NPI | 1700234754 |
---|---|
Former Name | JENNA RENEE BLECHMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5226) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV008666) |
152W00000X Optometrist (Licence: TX 10189TG) | |
Enumeration Date | 2016-06-01 |
Last Update Date | 2023-10-23 |