Organization
STACEY L. WILDA, O.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACEY LYN WILDA O.D. (PRESIDENT OWNER OPTOMETRIST)
(580) 336-0777
Entity
Organization
Contact information
Practice address
415 N 7TH ST, PERRY, OK 73077-6407
(580) 336-0777
(580) 336-0888
Mailing address
415 N 7TH ST, PERRY, OK 73077-6407
(580) 336-0777
(580) 336-0888
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2236
OK
Other
Enumeration date
03/28/2007
Last updated
12/08/2008
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