NPI 1508967282

Ronald Wayne Henson, OD

Practitioner Optometrist Delavan, WI

Practice location

Address: 1819 E Geneva St, Delavan, WI 53115-2037
Phone: (262) 740-7213
Fax: (262) 740-7226
Mailing address: 2305 Ramshead CT, Waukesha, WI 53188-1562

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 1267 (WI)

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Registry record

NPI: 1508967282
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Sep 2006
Record last updated: 8 Jul 2007

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.