Individual
ALISA NOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
7700 E KELLOGG DR, WICHITA, KS 67207-1772
(316) 685-1802
Mailing address
6 LAKEWOOD DR, GODDARD, KS 67052-9256
(316) 512-1171
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1987
KS
152W00000X
Optometrist
3386
MN
152WV0400X
Vision Therapy Optometrist
8861T
TX
Other
Enumeration date
06/21/2014
Last updated
10/27/2020
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