Provider Demographics
NPI:1639609282
Name:WOOLERY, MEGAN (OD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:WOOLERY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:FOWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:7609 W 67TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-9004
Mailing Address - Country:US
Mailing Address - Phone:605-362-2970
Mailing Address - Fax:605-361-4150
Practice Address - Street 1:3600 S LOUISE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-6326
Practice Address - Country:US
Practice Address - Phone:605-362-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD739152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist