Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 18003568A | IN |
N | 152W00000X | Optometrist | TA1878 | MD |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | TA1878 | MD |
N | 152WP0200X | Pediatric Optomitrist | TA1878 | MD |
N | 152WS0006X | Sports Vision | TA1878 | MD |
N | 152WV0400X | Optomitrist - Vision Therapist | TA1878 | MD |
N | 152WX0102X | Occupational Vision | TA1878 | MD |
NPI | 1215965454 |
---|---|
Provider Name | Dr. Amy H Layman |
First Address | Elkhart, IN 46514-1364 |
Second Address | Elkhart, IN 46514-1364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U83620 | (02) | MD |