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1003828740
BRAD J LAVALLIE
GREEN BAY, WI
NPI
1003828740
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: WI 2706)
Enumeration Date
2006-08-12
Last Update Date
2024-04-09
Business Address
BRAD J LAVALLIE OD
2253 W MASON ST
GREEN BAY, WI 54303-4706
Phone number: 920-327-7000
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Mailing Address
BRAD J LAVALLIE OD
1035 KEPLER DR
GREEN BAY, WI 54311-8320
Phone number: 920-490-9046
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