Individual
SYLVIA REBECCA MISHOULAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1310 E 79TH AVE, MERRILLVILLE, IN 46410-5768
(219) 641-6406
Mailing address
1310 E 79TH AVE, MERRILLVILLE, IN 46410-5768
(219) 641-6406
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003683A
IN
Other
Enumeration date
07/05/2011
Last updated
08/29/2015
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