Individual
DR. MARIMEL S. TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
(318) 990-4752
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1417-540AT
LA
Other
Enumeration date
09/07/2006
Last updated
10/16/2015
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