Individual
DR. DERRICK GENE PRENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2150 DEMING WAY, MIDDLETON, WI 53562-5507
(608) 824-3963
Mailing address
17 SHERMAN TER UNIT 1, MADISON, WI 53704-4440
(507) 313-2001
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4010-35
WI
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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