Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2584 | WI |
NPI | 1013017367 |
---|---|
Provider Name | Dr. Bartley J Behling |
First Address | Sheboygan Falls, WI 53085-1829 |
Second Address | Sheboygan, WI 53081-4206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38611400 | (05) | WI |