Individual
COLLEEN NICOLE KONKEL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4344 MORMON COULEE RD, LA CROSSE, WI 54601-7908
(608) 788-8800
Mailing address
4344 MORMON COULEE RD, LA CROSSE, WI 54601-7908
(608) 788-8800
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2780
MN
152W00000X
Optometrist
Primary
2845
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38612600
—
WI
Enumeration date
05/10/2006
Last updated
07/08/2007
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