Individual
CARA VANDER WILT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5501 NW 86TH ST STE 500, JOHNSTON, IA 50131-1815
(515) 270-0494
(515) 270-6463
Mailing address
110 S 19TH CT, INDIANOLA, IA 50125-4725
(515) 490-8103
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02289
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124012869
—
IA
Enumeration date
09/08/2005
Last updated
08/14/2023
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