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1184620049
C. WALLACE LILES
MENA, AR
NPI
1184620049
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: AR AR2331)
Enumeration Date
2005-06-24
Last Update Date
2019-06-03
Business Address
C. WALLACE LILES O.D.
208 MORROW ST S
MENA, AR 71953-2510
Phone number: 479-394-4215
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Mailing Address
C. WALLACE LILES O.D.
703J HIGHWAY 71 N
MENA, AR 71953-4395
Phone number: 479-394-4215
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