| NPI | 1417060104 |
|---|---|
| Former Name | JESSICA LYNN SCHIPMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MT 787) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 2887AT) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2010-05-19 |