NPI 1386687333

Michael Desmond Main, OD

Practitioner Optometrist Wisconsin Rapids, WI

Practice location

Address: 1220 Parkwood Dr, Wisconsin Rapids, WI 54494-5488
Phone: (715) 421-2111
Fax: (715) 421-2123
Mailing address: 1950 Old Gallows Rd STE 520, Vienna, VA 22182-3970

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 3021-035 (WI)

Other Optometrist providers in Wisconsin →

Registry record

NPI: 1386687333
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Jun 2006
Record last updated: 24 May 2021

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.