Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 4923/T1793 | OH |
NPI | 1013968353 |
---|---|
Provider Name | Dr. Andrea L Earley |
First Address | Twinsburg, OH 44087-1897 |
Second Address | Twinsburg, OH 44087-1897 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U71829 | (02) |