Individual
DR. KEVIN CONGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O. D.
Contact information
Practice address
3003 CLEVELAND AVE, SUITE A, MARINETTE, WI 54143
(715) 732-2101
Mailing address
W1417 AUTUMN WOOD LN, MARINETTE, WI 54143-9417
(715) 732-9110
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2071-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38527200
—
WI
Enumeration date
03/22/2007
Last updated
01/16/2017
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