NPI | 1114295789 |
---|---|
Other Name | AMY DEE-LYTE KEENE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2286) |
Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618002153) |
152W00000X Optometrist (Licence: TN 3007) | |
152W00000X Optometrist (Licence: WV 2055-IOD) | |
Enumeration Date | 2011-12-09 |
Last Update Date | 2022-11-25 |