Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4901003092 | MI |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 4901003092 | MI |
NPI | 1134118912 |
---|---|
Provider Name | Dr. Cheryl Vincent-Riemer |
First Address | Dallas, TX 75320-8177 |
Second Address | East Lansing, MI 48823-1438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 18/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U40359 | (02) | MI |