Organization
MILTON & EDGERTON VISION CENTERS, LLC
Active
Other names
Edgerton Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYME NICOLE LONG OD (DOCTOR/CO-OWNER)
(608) 884-3314
Entity
Organization
Contact information
Practice address
1110 N MAIN ST, EDGERTON, WI 53534-1328
(608) 884-3314
(608) 884-4923
Mailing address
1110 N MAIN ST, EDGERTON, WI 53534-1328
(608) 884-3314
(608) 884-4923
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1749
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38514300
—
WI
Enumeration date
05/17/2007
Last updated
02/07/2022
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