Provider Demographics
NPI:1144609322
Name:SWANSON EYE CARE INC
Entity Type:Organization
Organization Name:SWANSON EYE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:608-341-9636
Mailing Address - Street 1:2900 S WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:RICE LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54868-8578
Mailing Address - Country:US
Mailing Address - Phone:608-341-9636
Mailing Address - Fax:
Practice Address - Street 1:2900 S WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868-8578
Practice Address - Country:US
Practice Address - Phone:608-341-9636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center