Provider Demographics
NPI:1942305149
Name:SATTERLUND, DANIEL CHARLES (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:CHARLES
Last Name:SATTERLUND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 KELLER AVE N
Mailing Address - Street 2:
Mailing Address - City:AMERY
Mailing Address - State:WI
Mailing Address - Zip Code:54001-1034
Mailing Address - Country:US
Mailing Address - Phone:715-268-9010
Mailing Address - Fax:715-268-5231
Practice Address - Street 1:120 KELLER AVE N
Practice Address - Street 2:
Practice Address - City:AMERY
Practice Address - State:WI
Practice Address - Zip Code:54001-1034
Practice Address - Country:US
Practice Address - Phone:715-268-9010
Practice Address - Fax:715-268-5231
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2148-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38531200Medicaid
WIT63190Medicare UPIN
WI38531200Medicaid