Organization Name: | WILLIAM J WICKLINE OD INC |
NPI Number: | 1184894016 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM J WICKLINE (PRESIDENT) |
Mailing Address: | 680 W Washington St Ste E102 Sequim |
State: | WA US |
Postal Code: | 983823264 |
Phone Number: | 3606813937 |
Fax Number: | 3606812744 |
NPI Enumeration Date: | 03/06/2008 |
NPI Last Update Date: | 03/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | OD00001525 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |