| NPI | 1730743519 |
|---|---|
| Former Name | ALYSSA MARIE BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18004323A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046011339) |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2025-07-01 |