| NPI | 1598739302 | 
|---|---|
| Former Name | THERESA SUZANNE ORENCHAK | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 07150T) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA OE005031T) | 
| 152W00000X Optometrist (Licence: NJ 27OA00363700) | |
| 152W00000X Optometrist (Licence: FL OP 1421) | |
| Enumeration Date | 2006-02-16 | 
| Last Update Date | 2011-08-22 |