Organization
LADD F. KORESCH O.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LADD F. KORESCH O.D. (OPTOMETRIST)
(262) 248-4878
Entity
Organization
Contact information
Practice address
415 BROAD ST, SUITE 101, LAKE GENEVA, WI 53147-1800
(262) 248-4878
(262) 248-1100
Mailing address
415 BROAD ST, SUITE 101, LAKE GENEVA, WI 53147-1800
(262) 248-4878
(262) 248-1100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1228-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38556600
—
WI
Enumeration date
06/08/2007
Last updated
08/22/2020
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