| NPI | 1992267017 |
|---|---|
| Former Name | KELSEY RAE CRAWFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 3019) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 9818TG) |
| 332H00000X Eyewear Supplier (Licence: TX 9818TG) | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2023-01-24 |