NPI 1265483168

Shopko Stores Operating,co.,llc

Organisation Optometrist Oregon, WI

Practice location

Address: 6218 Trail Ridge CT, Oregon, WI 53575-2534
Phone: (608) 222-9420
Fax: (608) 222-0578

Authorised official

Name: Richard Dewey Olson
Title: Optomotrist
Phone: (608) 222-9420

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 1772 (WI)

Other Optometrist providers in Wisconsin →

Registry record

NPI: 1265483168
Entity type: Organization
NPI issued: 15 May 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.