Individual
DR. MELISSA MARIE WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
121 LOU ANN DR, HERRIN, IL 62948-3733
(618) 201-6725
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
5182
OH
152W00000X
Optometrist
Primary
—
IL
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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