| NPI | 1962693317 |
|---|---|
| Former Name | ERICA LYNN OWEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WV 1052-OD) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5734) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2014-06-03 |