Busisiwe Rose Vandriel O.D.

NPI 1043403967 - Optometrist - 152W00000X

NPI Details
NPI 1043403967
Gender Female
Enumeration Date 08/23/2007
Last Updated 07/29/2014
Entity Type Individual
Active Over 9 years ago
Practice Location
200 S 18TH AVE
WAUSAU WI, 54401-4252, US
Phone (715) 842-8040
Fax (715) 848-8773
Business Location
200 S 18TH AVE
WAUSAU WI, 54401-4252, US
Phone (715) 842-8040
Fax (715) 848-8773
Toxanomy
Taxonomy Code 152W00000X
License State Minnesota
License Number 3081
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According to our database, Busisiwe Rose Vandriel O.D. NPI is 1043403967, taxonomy code is 152W00000X and license number is 3081, license state is located at Minnesota. Busisiwe Rose Vandriel O.D. physically located at 200 S 18th Ave, Wausau WI, 54401-4252. NPI Number Busisiwe Rose Vandriel O.D. has the Individual type.

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1043403967 NPI number is provided on an as is basis without warranty of any kind. 1043403967 is maintained by the National Plan & Provider Enumeration System. The contents of Busisiwe Rose Vandriel O.D. are for informational purposes only.