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1861440612
JENNIFER WALLER
SPRINGFIELD, IL
NPI
1861440612
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: IL 046009087)
Enumeration Date
2006-05-04
Last Update Date
2023-02-03
Business Address
Dr. JENNIFER WALLER OD
2020 W ILES AVE
SPRINGFIELD, IL 62704-4174
Phone number: 217-698-3030
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Mailing Address
Dr. JENNIFER WALLER OD
600 S 8TH ST
BENLD, IL 62009-1446
Phone number: 217-835-7724
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