Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1073845632 |
---|---|
Provider Name | Christopher J Pals |
First Address | Chippewa Falls, WI 54729-1422 |
Second Address | Chippewa Falls, WI 54729-1422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2010 |
Last Update Date | 08/02/2010 |