Individual
EDWARD KOUTNIK II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2300 US HIGHWAY 51 AND 138 STE E, STOUGHTON, WI 53589-2080
(608) 205-6810
(608) 205-6813
Mailing address
2300 US HIGHWAY 51 AND 138 STE E, STOUGHTON, WI 53589-2080
(608) 205-6810
(608) 205-6813
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3612-35
WI
Other
Enumeration date
07/14/2015
Last updated
07/23/2024
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