Provider Demographics
NPI:1184729972
Name:NORTHWOODS FAMILY EYECARE, LLC
Entity type:Organization
Organization Name:NORTHWOODS FAMILY EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:G
Authorized Official - Last Name:ARNESON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:715-239-6210
Mailing Address - Street 1:PO BOX 797
Mailing Address - Street 2:
Mailing Address - City:CORNELL
Mailing Address - State:WI
Mailing Address - Zip Code:54732
Mailing Address - Country:US
Mailing Address - Phone:715-239-6210
Mailing Address - Fax:
Practice Address - Street 1:27477 STATE HWY 64, SUITE C
Practice Address - Street 2:
Practice Address - City:CORNELL
Practice Address - State:WI
Practice Address - Zip Code:54732
Practice Address - Country:US
Practice Address - Phone:715-239-6210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty