Individual
BETHANY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1365 S ALMA SCHOOL RD, MESA, AZ 85210-2085
(480) 615-9852
Mailing address
101 W 5TH ST APT 2041, TEMPE, AZ 85281-0205
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-2319
AZ
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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