Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OE-006240T | PA |
NPI | 1003836883 |
---|---|
Provider Name | Donna M Fitt |
First Address | Plymouth Meeting, PA 19462-1301 |
Second Address | Plymouth Meeting, PA 19462-1301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |