Organization
MILTON & EDGERTON VISION CENTERS, LLC
Active
Other names
Milton Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAYME NICOLE KASTING LONG (OPTOMETRIST/CO-OWNER)
(608) 868-4651
Entity
Organization
Contact information
Practice address
641 E SAINT MARY ST, MILTON, WI 53563-3719
(608) 868-4651
(608) 884-4923
Mailing address
641 E SAINT MARY ST, MILTON, WI 53563-3719
(608) 868-4651
(608) 868-9142
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
05/22/2007
Last updated
09/13/2021
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