Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FC0801X | Contact Lens Fitter | VA |
NPI | 1568998078 |
---|---|
Provider Name | Anita Grace Carpenter |
First Address | Richmond, VA 23226-3330 |
Second Address | Richmond, VA 23226-3330 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2017 |
Last Update Date | 03/05/2017 |