Organization
ESSENTIAL FAMILY VISION CARE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIA B. EDWARDS O.D. (PRESIDENT)
(608) 846-5625
Entity
Organization
Contact information
Practice address
101 S. MAIN ST, DE FOREST, WI 53532
(608) 846-5625
(608) 846-8998
Mailing address
101 S. MAIN ST, DE FOREST, WI 53532
(608) 846-5625
(608) 846-8998
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2173
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38723200
—
WI
Enumeration date
03/26/2007
Last updated
04/13/2009
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