| NPI | 1245964949 |
|---|---|
| Former Name | KAYLA KENNETTE TUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 3935) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT007092) |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2025-02-19 |