Provider Demographics
NPI:1982772547
Name:HULL & WILLIQUETTE, LTD
Entity Type:Organization
Organization Name:HULL & WILLIQUETTE, LTD
Other - Org Name:EYEWEAR EXPRESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:K
Authorized Official - Last Name:HULL
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:715-365-1515
Mailing Address - Street 1:232 S COURTNEY ST
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-3319
Mailing Address - Country:US
Mailing Address - Phone:715-365-1515
Mailing Address - Fax:715-365-1518
Practice Address - Street 1:232 S COURTNEY ST
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-3319
Practice Address - Country:US
Practice Address - Phone:715-365-1515
Practice Address - Fax:715-365-1518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38710400Medicaid