NPI 1780704049

Stewart Avenue Optical, INC.

Organisation Eye Bank Wausau, WI

Practice location

Address: 2100 Stewart Ave STE 120, Wausau, WI 54401-1707
Phone: (715) 845-1988
Fax: (715) 842-8793

Authorised official

Name: Nicole Lyons
Title: President
Phone: (715) 845-1988

Registered specialties

Eye Bank Primary

Suppliers Taxonomy 332G00000X Licence 2629 (WI)

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Registry record

NPI: 1780704049
Entity type: Organization
NPI issued: 30 Mar 2007
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.