Organization
WAL-MART STORES EAST, LP
Active
Other names
Vision Center 30-1167
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY C WILKINSON (CARRIER SPECIALIST)
(479) 204-8320
Entity
Organization
Contact information
Practice address
3500 BRUMBACK BLVD, SOMERS, WI 53144
(262) 652-1039
Mailing address
702 SW 8TH STREET, BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
07/01/2009
Last updated
07/01/2009
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