Individual
DESIREE ALEXIS WHEELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3450 E REZANOF DR, KODIAK, AK 99615
(907) 486-5504
Mailing address
3450 E REZANOF DR, KODIAK, AK 99615-6953
(907) 486-5504
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046.011252
IL
152W00000X
Optometrist
Primary
148261
AK
152W00000X
Optometrist
OFC89
FL
Other
Enumeration date
10/02/2018
Last updated
01/04/2021
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