Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | SC7110 | OH |
NPI | 1033662911 |
---|---|
Provider Name | Dana Meeks |
First Address | Hamilton, OH 45011-6078 |
Second Address | Fairfield, OH 45014-3006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2016 |
Last Update Date | 27/12/2019 |