Alfonso-Kneiert, Carmen M

Alfonso-Kneiert, Carmen M is an individual health care provider with primary practice located at 740 Reena Ave Suite B, Fort Atkinson WI 53538-3145. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Alfonso-Kneiert, Carmen M can be contacted via phone (920) 563-8468.

Contact Information

Primary practice address
740 Reena Ave Suite B Fort Atkinson WI 53538-3145
Fax: (920) 563-0178
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2485-035 Wisconsin

Profile Details

NPI number 1710938634
LBN Legal business name Alfonso-Kneiert, Carmen M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated Oct 27th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710938634 NPPES
Wisconsin MEDICAID 1710938634

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