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Individual

MRS. TINA MARIE WILLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OPTOMETRY TECH

Contact information

Practice address
126 MISSOURI AVE. EENT CLINIC, JENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL, FORT LEONARD WOOD, MO 65473
(573) 596-0131
(573) 596-0086
Mailing address
126 MISSOURI AVE. EENT CLINIC, JENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL, FORT LEONARD WOOD, MO 65473
(573) 596-0131
(573) 596-0086

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
09/09/2010
Last updated
09/09/2010
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