Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 5984 | OH |
NPI | 1013220433 |
---|---|
Provider Name | Dr. Alicia W Tobe |
First Address | Coldwater, OH 45828-1747 |
Second Address | Coldwater, OH 45828-1747 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2010 |
Last Update Date | 28/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3130552 | (05) | OH |
4302401 | (02) | OH |