| NPI | 1548257926 |
|---|---|
| Former Name | KIMBERLY LYNN RECKELHOFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003375A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046-009375) |
| 152W00000X Optometrist (Licence: MO 2001024149) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2007-07-08 |