Organization
WAL-MART STORES INC
Active
Other names
Wal-Mart Vision Center 30-5992
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNA PAINTER (ENROLLMENT SPECIALIST)
(479) 277-1238
Entity
Organization
Contact information
Practice address
20710 KEOKUK AVE, LAKEVILLE, MN 55044-6620
(952) 469-3944
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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