Individual
TAWANNA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 PEACH BLOSSOM DR APT 601, JEFFERSONVILLE, IN 47130-8491
(502) 649-7786
Mailing address
3001 PEACH BLOSSOM DR APT 601, JEFFERSONVILLE, IN 47130-8491
(502) 649-7786
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
IN
Other
Enumeration date
02/28/2026
Last updated
02/28/2026
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