Provider Demographics
NPI:1982896908
Name:JOE PRELL, OD
Entity Type:Organization
Organization Name:JOE PRELL, OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:608-524-4334
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:REEDSBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53959-0309
Mailing Address - Country:US
Mailing Address - Phone:608-524-4334
Mailing Address - Fax:
Practice Address - Street 1:251 2ND ST
Practice Address - Street 2:
Practice Address - City:REEDSBURG
Practice Address - State:WI
Practice Address - Zip Code:53959-1610
Practice Address - Country:US
Practice Address - Phone:608-524-4334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty