Provider Demographics
NPI:1841504727
Name:VOLLWILER, LOUISE ANN (OD)
Entity type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:ANN
Last Name:VOLLWILER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7467 ALYCIA DR
Mailing Address - Street 2:
Mailing Address - City:HUDSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49426-7519
Mailing Address - Country:US
Mailing Address - Phone:616-662-1729
Mailing Address - Fax:
Practice Address - Street 1:12737 COTTON LAKE ROAD
Practice Address - Street 2:SAM'S CLUB STORE NO.6429
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017
Practice Address - Country:US
Practice Address - Phone:269-979-7704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002933152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist