Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TA2599 | MD |
NPI | 1003338260 |
---|---|
Provider Name | Dana Reinhardt |
First Address | Vienna, VA 22182-3990 |
Second Address | Nottingham, MD 21236-4088 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2017 |
Last Update Date | 31/01/2018 |