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General NPI Number Information
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NPI Number | 1124246558
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Entity Type | Organization
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Legal Business Name | EYE CONTACT LLC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 7428 MINERAL PT RD
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City | MADISON
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State | WI
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Zip | 53717
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Country | US
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Telephone | 608-833-3937
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Fax | 608-833-4248
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Provider Business Mailing Address
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Address Line | 7428 MINERAL POINT RD
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City | MADISON
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State | WI
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Zip | 53717-1710
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Country | US
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Telephone | 608-833-3937
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Fax | 608-833-4248
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZACHARY MAKAL
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Credential |
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Telephone | 608-833-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2097
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License Number State | WI
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