Provider Demographics
NPI:1144411851
Name:DR.S MELCHER AND SPRAGUE
Entity type:Organization
Organization Name:DR.S MELCHER AND SPRAGUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:715-669-5631
Mailing Address - Street 1:PO BOX 468
Mailing Address - Street 2:
Mailing Address - City:THORP
Mailing Address - State:WI
Mailing Address - Zip Code:54771-0468
Mailing Address - Country:US
Mailing Address - Phone:715-669-5631
Mailing Address - Fax:
Practice Address - Street 1:102 E STANLEY ST
Practice Address - Street 2:
Practice Address - City:THORP
Practice Address - State:WI
Practice Address - Zip Code:54771-9649
Practice Address - Country:US
Practice Address - Phone:715-669-5631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty