Individual
LINDA AILEEN WILLS HEASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10301 DAWSONS CREEK BLVD, SUITE 2A, FORT WAYNE, IN 46825-1955
(260) 489-3996
(260) 497-8612
Mailing address
10301 DAWSONS CREEK BLVD, SUITE 2A, FORT WAYNE, IN 46825-1955
(260) 489-3996
(260) 497-8612
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002550B
IN
Other
Enumeration date
07/10/2007
Last updated
01/30/2012
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