| NPI | 1245644350 |
|---|---|
| Former Name | CARRIE M LEISTNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT003724) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 008166) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2026-05-19 |