Organization
GUNDERSEN CLINIC, LTD.
Active
Parent organization
GUNDERSEN CLINIC, LTD.
Other names
GL Vision Center - Viroqua
Organization subpart
Yes
Provider details
NPI number
Legal business name
GUNDERSEN CLINIC, LTD.
Authorized official
KARI B ADANK (CCO)
(608) 775-8025
Entity
Organization
Contact information
Practice address
407 S MAIN ST, SUITE 103, VIROQUA, WI 54665-2057
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023450029
DMERC SUPPLIER
WI
Enumeration date
06/12/2006
Last updated
08/06/2021
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