Organization
PROGRESSIVE FAMILY EYECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADY HAFERMAN O.D. (OPTOMETRIST/OWNER)
(608) 873-2020
Entity
Organization
Contact information
Practice address
105 KINGS LYNN RD, STOUGHTON, WI 53589-1999
(608) 873-2020
Mailing address
105 KINGS LYNN RD, STOUGHTON, WI 53589-1999
(608) 873-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3075-35
WI
Other
Enumeration date
12/04/2015
Last updated
01/04/2016
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