| NPI | 1568897890 |
|---|---|
| Former Name | MELISSA ANN VANZIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV 2005-IOD) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OEG002787) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2018-02-10 |