Individual
MISTY MARIE WATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
310 W MAIN ST, SPARTA, WI 54656
(608) 785-0940
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
(608) 785-0940
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3079-035
WI
Other
Enumeration date
07/10/2007
Last updated
09/15/2020
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