| NPI | 1215283668 |
|---|---|
| Former Name | RACHEL L THELEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 002686) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CO 2913) |
| 152W00000X Optometrist (Licence: MI 4901004947) | |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2023-04-21 |