Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT-OPT-LIC-1938 | MT |
NPI | 1003918384 |
---|---|
Provider Name | Barbara Suzanne Cohn |
First Address | Crow Agency, MT 59022-0009 |
Second Address | Crow Agency, MT 59022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V12212 | (02) | MT |