Organization
W E MARIONNEAUX JR OD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLARD E MARIONNEAUX JR. OD (OPTOMETRIST OWNER)
(318) 435-5145
Entity
Organization
Contact information
Practice address
6609 MAIN ST, WINNSBORO, LA 71295-2763
(318) 435-5145
(318) 435-9476
Mailing address
PO BOX 910, WINNSBORO, LA 71295-0910
(318) 435-5145
(318) 435-9476
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
712 014 T
LA
Other
Enumeration date
08/15/2007
Last updated
01/28/2008
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