Individual
DR. BRAD HAROLD EWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2900 S MAIN ST, RICE LAKE, WI 54868
(715) 234-1511
(715) 434-1513
Mailing address
2900 S MAIN ST, RICE LAKE, WI 54868
(715) 234-1511
(715) 434-1513
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1347-035
WI
Other
Enumeration date
03/27/2007
Last updated
12/09/2008
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