Individual
DANIEL SPENCER PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
833 N CASS ST, WABASH, IN 46992-1613
(260) 563-3672
Mailing address
9714 W 125TH AVE, CEDAR LAKE, IN 46303-9259
(708) 439-9447
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
006791
OH
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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