NPI | 1710339692 |
---|---|
Former Name | KARA LYNN VITUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: PA OEG003255) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OH OPT6586) |
152W00000X Optometrist (Licence: TN 3295) | |
Enumeration Date | 2016-07-05 |
Last Update Date | 2018-09-20 |