Organization
WILSON FAMILY EYECARE PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L WILSON (OWNER)
(509) 786-3111
Entity
Organization
Contact information
Practice address
617 MARKET ST, PROSSER, WA 99350-1341
(509) 786-3111
(509) 786-3188
Mailing address
617 MARKET ST, PROSSER, WA 99350-1341
(509) 786-3111
(509) 786-3188
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001687
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023131
—
WA
Enumeration date
10/24/2012
Last updated
10/24/2012
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