Provider Demographics
NPI:1598998908
Name:WILSON, JANET MONACO (OD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:MONACO
Last Name:WILSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:L
Other - Last Name:MONACO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:142 FERNWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307
Mailing Address - Country:US
Mailing Address - Phone:864-308-8812
Mailing Address - Fax:864-308-8813
Practice Address - Street 1:142 FERNWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307
Practice Address - Country:US
Practice Address - Phone:864-308-8812
Practice Address - Fax:864-308-8813
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1526152W00000X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152W00000XEye and Vision Services ProvidersOptometrist