Individual
MAKAY BRYANT NEILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(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
3629
WI
152W00000X
Optometrist
ODP-100310
ID
Other
Enumeration date
10/19/2011
Last updated
09/28/2020
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