Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 18003615A | IN |
NPI | 1003046871 |
---|---|
Provider Name | Dr. Erin Michelle Buck |
First Address | Greenwood, IN 46142-1567 |
Second Address | Greenwood, IN 46142-1567 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2009 |
Last Update Date | 13/05/2013 |