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Individual

DR. KENDRA ERICKSON GARBRECHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
2104 STATE ROAD 16, LA CROSSE, WI 54601-3046
(608) 782-7127
(608) 782-7124
Mailing address
N4637 TIMBERCREST DR E, ONALASKA, WI 54650-8623
(608) 799-4138
(608) 781-1590

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
02325
IA
152W00000X
Optometrist
Primary
3129-035
WI
152W00000X
Optometrist
3263
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1215110424
GROUP NPI
IA
01
870360007
INDIVIDUAL PTAN
WI
Enumeration date
09/15/2006
Last updated
01/24/2012
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