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1013909753
THEODORE M WANDZILAK
LOUISVILLE, KY
NPI
1013909753
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207W00000X Ophthalmology
(Licence: KY 22152)
Enumeration Date
2005-08-18
Last Update Date
2008-01-09
Business Address
-- THEODORE M WANDZILAK MD
1348 POPLAR LEVEL RD
LOUISVILLE, KY 40217-1307
Phone number: 502-634-8100
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Mailing Address
-- THEODORE M WANDZILAK MD
1348 POPLAR LEVEL RD
LOUISVILLE, KY 40217-1307
Phone number: 502-634-8100
Copy
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