Individual
CARLA DEANN SHOULTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3107 GOLDENROD AVE, GILLETTE, WY 82716-2287
(307) 689-5798
Mailing address
2300 S DOUGLAS HWY, GILLETTE, WY 82718-5420
(307) 685-8108
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
317T
WY
Other
Enumeration date
11/06/2007
Last updated
08/22/2008
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