Individual
HEATHER MARIE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 FRANCES LN, BEAVER DAM, WI 53916-1165
(920) 885-8463
(920) 885-9034
Mailing address
120 FRANCES LN, BEAVER DAM, WI 53916-1165
(920) 885-8463
(920) 885-9034
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
246799
WI
Other
Enumeration date
05/29/2023
Last updated
05/29/2023
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