Individual
BRENDA S WEDIG
Active
Sole proprietor
No
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
Mailing address
2104 STATE ROAD 16, LA CROSSE, WI 54601-3046
(608) 782-7127
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3192
MN
152W00000X
Optometrist
Primary
WI 3116-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38645900
—
WI
Enumeration date
08/04/2008
Last updated
10/13/2009
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