Provider Demographics
NPI:1588820773
Name:HESS, MARISA (OPTOMETRIST)
Entity Type:Individual
Prefix:DR
First Name:MARISA
Middle Name:
Last Name:HESS
Suffix:
Gender:F
Credentials:OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-2630
Mailing Address - Country:US
Mailing Address - Phone:406-222-0250
Mailing Address - Fax:406-222-8419
Practice Address - Street 1:305 W PARK ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-2630
Practice Address - Country:US
Practice Address - Phone:406-222-0250
Practice Address - Fax:406-222-8419
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT801152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist