Individual
RENEE LYNN WALDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
8201 MISH KO SWEN DR, CRANDON, WI 54520-8631
(715) 478-4300
Mailing address
9188 GOLF VIEW DR, MINOCQUA, WI 54548-9268
(715) 358-1978
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1482DT
KY
152W00000X
Optometrist
Primary
3068-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38643900
—
WI
Enumeration date
08/16/2005
Last updated
04/13/2015
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