Provider Demographics
NPI:1982088944
Name:CLEAR APPROACH OPTOMETRY SC
Entity Type:Organization
Organization Name:CLEAR APPROACH OPTOMETRY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERLOOP
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:920-205-5810
Mailing Address - Street 1:1901 CROOKS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:KAUKAUNA
Mailing Address - State:WI
Mailing Address - Zip Code:54130-3200
Mailing Address - Country:US
Mailing Address - Phone:920-372-2555
Mailing Address - Fax:920-949-4025
Practice Address - Street 1:1901 CROOKS AVE STE C
Practice Address - Street 2:
Practice Address - City:KAUKAUNA
Practice Address - State:WI
Practice Address - Zip Code:54130-3200
Practice Address - Country:US
Practice Address - Phone:920-372-2555
Practice Address - Fax:920-949-4025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty