Provider Demographics
NPI:1821888223
Name:WISCONSIN VISION ASSOCIATES
Entity type:Organization
Organization Name:WISCONSIN VISION ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-747-9000
Mailing Address - Street 1:35263 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-1255
Mailing Address - Country:US
Mailing Address - Phone:800-747-9000
Mailing Address - Fax:800-294-3270
Practice Address - Street 1:35263 W STATE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-1255
Practice Address - Country:US
Practice Address - Phone:800-747-9000
Practice Address - Fax:800-294-3270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier