NPI | 1417323403 |
---|---|
Former Name | CHELSEA RYZUK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: SC 2270) |
Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG003118) |
152W00000X Optometrist (Licence: NJ 27oa00662500) | |
152W00000X Optometrist (Licence: GA OPT003379) | |
Enumeration Date | 2015-08-13 |
Last Update Date | 2022-11-30 |