Individual
DR. MALLORRE RAESCHELL DILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1001 N GRAND AVE, TAHLEQUAH, OK 74464-7017
(918) 444-4000
(918) 458-2104
Mailing address
1001 N GRAND AVE, TAHLEQUAH, OK 74464-7017
(918) 444-4000
(918) 458-2104
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2555
OK
Other
Enumeration date
11/18/2008
Last updated
08/18/2014
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