Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2122 | AZ |
NPI | 1003267030 |
---|---|
Provider Name | Dr. Amy Elizabeth Keding |
First Address | Scottsdale, AZ 85257-3575 |
Second Address | Scottsdale, AZ 85260 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2016 |
Last Update Date | 12/06/2019 |