Individual
DR. ISMAEL RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4237 LIEN RD STE E, MADISON, WI 53704-3686
(608) 819-0642
Mailing address
2515 GASTON RD #111, COTTAGE GROVE, WI 53718
(630) 901-4312
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3626-35
WI
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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