Glanville, Kristopher L
Glanville, Kristopher L is an individual health care provider with primary practice located at 3200 E Racine St , Janesville WI 53546. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Glanville, Kristopher L can be contacted via phone (608) 371-8000.Contact Information
Primary practice address
3200 E Racine St
Janesville WI 53546
Phone: (608) 371-8000
Fax: (608) 371-8907
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2924-035 | Wisconsin |
Profile Details
| NPI number | 1104825017 |
|---|---|
| LBN Legal business name | Glanville, Kristopher L |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2005 |
| Last updated | Dec 18th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104825017 | NPPES |
| Wisconsin | MEDICAID | 1104825017 |
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