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Individual

DR. JOLIE DENISE LEGATE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
10800 N PORT WASHINGTON RD, MEQUON, WI 53092-5007
(262) 241-4848
Mailing address
1128 COPRINUS DR, GREEN BAY, WI 54313-4210
(920) 471-7214

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3720-35
WI

Other

Enumeration date
12/04/2021
Last updated
12/12/2021
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