NPI | 1306973417 |
---|---|
Former Name | TRACY LYNN SCHROEDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: AL R-176-TA-786) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TN TN2229) |
152W00000X Optometrist (Licence: AL R176TA786) | |
Enumeration Date | 2007-02-27 |
Last Update Date | 2021-06-16 |