Individual
MARK WADE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2700 W COLLEGE AVE, APPLETON, WI 54914-2918
(920) 735-9580
Mailing address
2700 W COLLEGE AVE, APPLETON, WI 54914-2918
(920) 735-9580
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2210
WI
Other
Enumeration date
10/10/2005
Last updated
08/04/2023
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