Organization
EYE WISCONSIN LLC
Active
Parent organization
EYE WISCONSIN LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EYE WISCONSIN LLC
Authorized official
DR. BRADLEY GRANT OD (OWNER)
(217) 233-3101
Entity
Organization
Contact information
Practice address
1721 W MAIN ST, SUN PRAIRIE, WI 53590-3161
(608) 837-7325
Mailing address
1090 BUCKS POND RD, MONTICELLO, IL 61856-8058
(217) 233-3101
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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