Individual
LADONA JEAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1102 N MASSEY BLVD, NIXA, MO 65714-7607
(417) 724-1301
Mailing address
1102 N MASSEY BLVD, NIXA, MO 65714-7607
(417) 724-1301
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2010022297
MO
152W00000X
Optometrist
2669
AR
Other
Enumeration date
07/08/2010
Last updated
07/21/2022
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