Individual
DR. MARIANNE WANDA MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
10900 LINCOLN TRL, FAIRVIEW HEIGHTS, IL 62208-2042
(618) 398-5005
Mailing address
1218 ELISABETH DR, O FALLON, IL 62269-7159
(618) 624-3278
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
IL
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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