Provider Demographics
NPI:1235814906
Name:CARLI, JOSHUA D (OD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:D
Last Name:CARLI
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:3237 RIVERSIDE DR STE A
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-1643
Mailing Address - Country:US
Mailing Address - Phone:920-336-2020
Mailing Address - Fax:920-336-2709
Practice Address - Street 1:3237 RIVERSIDE DR STE A
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-1643
Practice Address - Country:US
Practice Address - Phone:920-336-2020
Practice Address - Fax:920-336-2709
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI3928-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist