Oconomowoc Vision Clinic, Llc

LBN: Oconomowoc Vision Clinic, Llc
Oconomowoc Vision Clinic, Llc is an health care organization with primary practice located at 1674 Old Schoolhouse Rd Suite 101, Oconomowoc WI 53066-1396. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Oconomowoc Vision Clinic, Llc can be contacted via phone (262) 567-2295, or through Bjork, David Mark via phone (262) 567-2295.

Contact Information

Primary practice address
1674 Old Schoolhouse Rd Suite 101 Oconomowoc WI 53066-1396
Phone: (262) 567-2295
Fax: (262) 567-0744
Website:
Map and Directions
Authorized official contact:
Name: Bjork, David Mark Doctor of Optometry (OD)
Phone: (262) 567-2295

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3017 Wisconsin

Profile Details

NPI number 1376724377
LBN Legal business name Oconomowoc Vision Clinic, Llc
DBA Doing business as
Authorized official Bjork, David Mark Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 18th, 2007
Last updated May 10th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376724377 NPPES
Other 1487726535 INDIVIDUAL NPI NUMBER
MEDICAID 38726800 INDIVIDUAL NPI NUMBER

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