GRIEBENOW EYECARE SC, Optometrist NEW LONDON, WI

Contact Information

GRIEBENOW EYECARE, S.C.

105 NORTHRIDGE DRIVE
NEW LONDON, WI 54961

Phone: 920-982-3711
Fax: 920-982-3009
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Optometrist	152W00000X	41	Optometry

Indicates primary specialty

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NPI Profile & details for GRIEBENOW EYECARE SC · (Female)

NPI Number	`1366599433`
Status	Active
Credentials
Entity	Individual
Enumeration date	01/04/2007
Last updated	08/19/2020 - About 6 years ago
Sole proprietor ¹	Not specified
Identifiers	WI Medicaid 38510500
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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