Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OEG000104 | PA |
NPI | 1003809401 |
---|---|
Provider Name | Dr. Devyn Lee Usuka |
First Address | Orwigsburg, PA 17961-1953 |
Second Address | Orwigsburg, PA 17961-1953 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 10/02/2008 |