Johansen, Lawrence
Johansen, Lawrence is an individual health care provider with primary practice located at 1000 W Northland Ave , Appleton WI 54914-1419. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Johansen, Lawrence can be contacted via phone (920) 731-4511.Contact Information
Primary practice address
1000 W Northland Ave
Appleton WI 54914-1419
Phone: (920) 731-4511
Fax: (920) 731-9332
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | WI 2007 | Wisconsin |
Profile Details
| NPI number | 1417908955 |
|---|---|
| LBN Legal business name | Johansen, Lawrence |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1417908955 | NPPES |
| Wisconsin | MEDICAID | 38525100 |
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