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Organization

SPRING GREEN VISION CENTER, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY L VODAK O.D. (OPTOMETRIST & OWNER)
(608) 588-2612
Entity
Organization

Contact information

Practice address
150 E JEFFERSON ST, SPRING GREEN, WI 53588-0100
(608) 588-2612
(608) 588-3227
Mailing address
150 E JEFFERSON ST, PO BOX 100, SPRING GREEN, WI 53588-0100
(608) 588-2612
(608) 588-3227

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1843
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1843
STATE LICENSE NUMBER
WI
Enumeration date
01/24/2007
Last updated
02/19/2008
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