Organization
LANCE ENGDAHL EYE CARE S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LANCE EDWARD ENGDAHL O.D. (PRESIDENT)
(262) 853-2664
Entity
Organization
Contact information
Practice address
6658 ODANA RD, MADISON, WI 53719-1012
(608) 829-3937
Mailing address
116 E LAKESIDE ST, MADISON, WI 53715-2028
(262) 853-2664
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2711-35
WI
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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