Organization
VINCENT R FACCHIANO & ASSOC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT R FACCHIANO O.D. (PRESIDENT)
(815) 332-2223
Entity
Organization
Contact information
Practice address
1 W TOWNE MALL, MADISON, WI 53719-1019
(608) 829-2440
(608) 833-2131
Mailing address
PO BOX 427, BELVIDERE, IL 61008-0427
(815) 332-2223
(815) 332-4488
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1865035
WI
Other
Enumeration date
08/11/2006
Last updated
11/16/2009
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