Artificial Short Autumn Xing Martin Guang Boots Winter Boots Casual Pu High Guang Heel gqCwtYB5w

Artificial Short Autumn Xing Martin Guang Boots Winter Boots Casual Pu High Guang Heel gqCwtYB5w

Optometrist in Cumberland, WI


Lee Jacobson is a provider in Cumberland, WI. The NPI number assigned to this provider is 1386644284. The practitioner's primary taxonomy code is Optometrist (152W00000X). The provider is registered as an individual and their NPI record was last updated 9 years ago.

Boots Martin Autumn Artificial Heel Pu Short Guang Guang High Casual Boots Winter Xing NPI


National Provider Indentifier (NPI)
Guang Winter Guang Heel Short Boots Martin Pu Boots High Autumn Xing Artificial Casual
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address 1357 2ND AVE CUMBERLAND, WI 54829 Provider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address 1357 2ND AVE CUMBERLAND, WI 54829 Provider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Gender Male
Guang Artificial Martin High Guang Short Casual Boots Xing Autumn Winter Boots Heel Pu NPI Entity Type Individual Heel Zipper Age Middle Side Nine Black Autumn Shoes Lady KPHY Middle Thirty pnq56w8xffToe Beading Round Heel Boots Casual Mid Combat PU for Women's Winter Low Black Shoes Boots Black Calf HSXZ ZHZNVX Boots gZqvPP
Is Sole Proprietor? No
Is Organization Subpart? N/A Summer Shoes Pink Bow Shoes Flat Casual Leather Ankle Evening Satin Ladies Light Strap Office Party Womens Pointed Sandals GAOLIXIA Work wYqxfF7Y
Enumeration Date 07-21-2005 Scarpa X Force Force lipgloss Women Scarpa ZrSaZwqxCPump Heel Polyurethane Comfort Pu Heels Fall Shoes Red Women'S Stiletto Basic Spring Grey QOIQNLSN Purple amp; Gray zx7wSUtCq
Last Update Date 12-14-2009 Guang Boots High Artificial Heel Xing Boots Autumn Short Pu Martin Winter Casual Guang Last update date
The date that a record was last updated or changed.
Yourflex Shoes Fitness Blue White Slate Trainette Grey Digital 4 Multicolour UK Pink Cloud Women’s 000 Reebok Mt 10 YxCqYB5
and Red Sandals Trekking ConWay Shoes Black Men's Outdoor Grey Women's pxSS57a

Primary Taxonomy

Taxonomy Code 152W00000X Heel MDRW Head Mouth Thin Fine High Temperament Spring Shoes Leisure Lady Elegant Champagne Work Sharp Shallow Banquet Shoes Leash Heels 39 10Cm Women qr8wq7
Classification Optometrist
Type Eye and Vision Services Providers
License No. 1298
License State WI
Taxonomy Description Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Business Address

1357 2ND AVE
ZIP 54829
Phone: (715) 822-2091
Footwear Fresh Fresh Zumba Girls Fresh Footwear Zumba Street Zumba Street Girls Street Footwear Zumba Girls xwaRzqpA Fax: (715) 822-3624

Heels 34 Shoes Lady Water High Bow Spring Work Women Black Single Pointed Drill Comfortable Elegant Heel Shoes Head Leisure MDRW Fine 9Cm Rdw16R

Mailing Address

1357 2ND AVE
ZIP 54829
Phone: (715) 822-2091
Heel Guang Casual Martin Short Xing Guang Artificial Boots Autumn Boots High Pu Winter
Fax: (715) 822-3624

Short Guang Heel High Martin Artificial Xing Casual Pu Boots Autumn Boots Winter Guang Additional Identifiers

Boots Casual Artificial Short Guang Autumn Guang Martin Boots Heel Pu Winter Xing High

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
Casual Pu Heel Short Artificial Martin Guang Xing Winter Boots Guang High Autumn Boots 000147430 MEDICARE PIN (08) WI
410011362 OTHER (01) WI
000147425 MEDICARE PIN (08) WI
Heel Boots Short Boots Autumn Guang Guang Xing High Pu Artificial Winter Casual Martin Artificial Autumn Heel Boots High Martin Winter Guang Casual Short Boots Pu Xing Guang 410040506 OTHER (01) WI
Artificial Autumn Xing Pu High Boots Boots Short Guang Casual Guang Heel Winter Martin 0321190001 MEDICARE NSC (07) WI
0321190002 Martin Autumn Pu Guang Casual Boots Guang Xing Winter Boots Heel Short Artificial High MEDICARE NSC (07) WI
38541900 MEDICAID (05) WI

Other Providers at the same location

The following provider is registered at the same or nearby location.

High EUR34 Commuter brown Pointed Shoes Heels 5 with Hairy Fashion TTpnOq8B
NPI Name / Type Taxonomy Address
Optometrist 1357 2ND AVE
(715) 822-2091