Provider Demographics
NPI:1164857769
Name:PERSPECTIVE VISION CARE LLC
Entity Type:Organization
Organization Name:PERSPECTIVE VISION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BJORK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:262-705-6958
Mailing Address - Street 1:105 E WISCONSIN AVE
Mailing Address - Street 2:206
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-3058
Mailing Address - Country:US
Mailing Address - Phone:262-354-8179
Mailing Address - Fax:
Practice Address - Street 1:105 E WISCONSIN AVE
Practice Address - Street 2:206
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-3058
Practice Address - Country:US
Practice Address - Phone:262-354-8179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3017152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty