Optometric Services, S.C.

Organization Active NPI Optometrist · Little Chute, WI

NPI 1306029616 · NPPES record last updated Jun 25, 2008

Key facts

NPI
1306029616
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
WI1829 (WI)
Legal business name
OPTOMETRIC SERVICES, S.C.
Practice address
607 Wilson St
Little Chute, WI 54140-1856
Phone
(920) 788-4162
Fax
(920) 788-6134
NPI assigned
Dec 10, 2007
Organization subpart
No

Authorized official

Name
Dr. John Elmer Salisbury, O.D.
Title
Owner / President
Phone
(920) 788-4162

National Provider Directory

Locations

607 Wilson St
Little Chute, WI 54140
Phone (920) 788-3542

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X WI1829 WI Yes

Addresses

Primary practice location

607 Wilson St
Little Chute, WI 54140-1856

Mailing address

607 Wilson St
Little Chute, WI 54140-1856
Phone (920) 788-4162

Other identifiers

IdentifierTypeStateIssuer
100000291OtherWEA

Other providers in Little Chute, WI

All providers in Little Chute, WI · Optometrist in Wisconsin

Sources for this page

Verify at the official NPI Registry.