Individual
MS. ALISSA H WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2860 S ALMA SCHOOL RD STE 28, CHANDLER, AZ 85248-3195
(480) 732-9040
Mailing address
1641 W LYNX WAY, CHANDLER, AZ 85248-5424
(480) 659-8812
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1142
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1142
STATE LICENSE
AZ
Enumeration date
01/22/2007
Last updated
07/09/2007
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