Individual
MARY ELLEN WITTENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(574) 272-9000
(574) 272-9010
Mailing address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(574) 272-9000
(574) 272-9153
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005437
MI
Other
Enumeration date
06/24/2020
Last updated
07/03/2023
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