NPI | 1285636084 |
---|---|
Other Name | CARRIE KIMBLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: WV 960-OD) |
Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1532DT) |
152W00000X Optometrist (Licence: OH 5264T2171) | |
Enumeration Date | 2005-08-11 |
Last Update Date | 2021-04-15 |