Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | ||
Y | 156FX1800X | Optician | MT |
NPI | 1205599198 |
---|---|
Provider Name | Cheyenne Morgan |
First Address | Missoula, MT 59801-6772 |
Second Address | Helena, MT 59601-8645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2021 |
Last Update Date | 18/10/2021 |