Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 5647 | OH |
NPI | 1114002292 |
---|---|
Provider Name | Dr. Catherine Marie Pannebaker |
First Address | Delaware, OH 43015-8388 |
Second Address | Columbus, OH 43210-1280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 08/07/2007 |