NPI | 1285755322 |
---|---|
Former Name | HEATHER M TEETER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: HI OD635) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CA 12888) |
Enumeration Date | 2007-04-03 |
Last Update Date | 2017-10-05 |