Individual
MRS. DEANNE MICHELLE WOLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
223 MAIN ST, FESTUS, MO 63028-1952
(636) 937-2399
(636) 937-4683
Mailing address
223 MAIN ST, FESTUS, MO 63028-1952
(636) 937-2399
(636) 937-4683
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2009017070
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922236678
—
MO
Enumeration date
07/01/2009
Last updated
12/02/2021
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