Gundersen Clinic, Ltd.

NPI #1578518346 in Sparta, Wisconsin

Provider Information

NPI Number: 1578518346
Entity Type: Organization
Organization Name: Gundersen Clinic, Ltd.
Subpart: Yes (part of a larger organization)
Parent Organization: GUNDERSEN CLINIC LTD
Primary Specialty: Optometrist
Enumeration Date: May 23, 2006
Last Updated: Aug 6, 2021

Practice Location

Address: 1111 W WISCONSIN ST
City: Sparta
State: Wisconsin
ZIP Code: 54656
Phone: (608) 782-7300

Authorized Official

Name: KARI B ADANK
Title: CCO
Phone: (608) 775-8025

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X
Durable Medical Equipment & Medical Supplies	332B00000X
Optometrist	152W00000X	Primary

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