| NPI | 1487140828 |
|---|---|
| Former Name | LAUREN MORIAH SHACKELFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2549) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-E16) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2023-12-06 |