Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1033 | MS |
NPI | 1003487463 |
---|---|
Provider Name | Anna Katherine Lansdell |
First Address | Saltillo, MS 38866-6895 |
Second Address | Saltillo, MS 38866-6895 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2021 |
Last Update Date | 07/07/2021 |