Provider Demographics
NPI:1427918846
Name:VIKTOR & MARIYA, LLC
Entity type:Organization
Organization Name:VIKTOR & MARIYA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DARYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:920-565-3991
Mailing Address - Street 1:300 AUDUBON RD
Mailing Address - Street 2:
Mailing Address - City:HOWARDS GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53083-1288
Mailing Address - Country:US
Mailing Address - Phone:920-565-3991
Mailing Address - Fax:920-565-4404
Practice Address - Street 1:300 AUDUBON RD
Practice Address - Street 2:
Practice Address - City:HOWARDS GROVE
Practice Address - State:WI
Practice Address - Zip Code:53083-1288
Practice Address - Country:US
Practice Address - Phone:920-565-3991
Practice Address - Fax:920-565-4404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty