NPI | 1366504839 |
---|---|
Former Name | ADRIENNE R. RICHARDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: AL S-956-TA-546) |
Additional Taxonomies | 152W00000X Optometrist (Licence: TN OD0000003441) |
152W00000X Optometrist (Licence: GA OPT001886) | |
Enumeration Date | 2006-12-14 |
Last Update Date | 2019-11-06 |