Komro, Nicholas Joel

Komro, Nicholas Joel is an individual health care provider with primary practice located at 520 Wilson Ave , Menomonie WI 54751-2516. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Komro, Nicholas Joel can be contacted via phone (715) 235-2855.

Contact Information

Primary practice address
520 Wilson Ave Menomonie WI 54751-2516
Phone: (715) 235-2855
Fax: (715) 235-9436
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2903-035 Wisconsin

Profile Details

NPI number 1750373585
LBN Legal business name Komro, Nicholas Joel
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Dec 29th, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750373585 NPPES
Wisconsin MEDICAID 38719700

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