Provider Demographics
NPI:1720270226
Name:EMMERICH VISION CARE, LLC
Entity Type:Organization
Organization Name:EMMERICH VISION CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:EMMERICH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:608-274-6747
Mailing Address - Street 1:5904 SCHUMANN DR
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-5103
Mailing Address - Country:US
Mailing Address - Phone:608-274-5246
Mailing Address - Fax:608-274-6793
Practice Address - Street 1:6321 MCKEE RD.
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53719
Practice Address - Country:US
Practice Address - Phone:608-274-6747
Practice Address - Fax:608-274-6793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1798152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty