Wicklund, Corinne Beiersdorf
Wicklund, Corinne Beiersdorf is an individual health care provider with primary practice located at 100 Carr Rd , Plymouth WI 53073-9500. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Wicklund, Corinne Beiersdorf can be contacted via phone (920) 892-3937.Contact Information
Primary practice address
100 Carr Rd
Plymouth WI 53073-9500
Phone: (920) 892-3937
Fax: (920) 892-6668
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 3046-035 | Wisconsin |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3046-035 | Wisconsin |
Profile Details
| NPI number | 1649290941 |
|---|---|
| LBN Legal business name | Wicklund, Corinne Beiersdorf |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2006 |
| Last updated | May 4th, 2022 - about 3 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 | 1649290941 | NPPES |
| Wisconsin | Other | 3046-035 | STATE LICENSE NUMBER |
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