| NPI | 1710025507 |
|---|---|
| Former Name | LAURA ANN WYNECOOP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD00001873TX) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: WA OD00001873TX) |
| 152WS0006X Optometrist, Sports Vision (Licence: WA OD00001873TX) | |
| 152WX0102X Optometrist, Occupational Vision (Licence: WA OD00001873TX) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2011-02-16 |