Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2199 | AZ |
NPI | 1003330549 |
---|---|
Provider Name | Dr. Karly Baier |
First Address | Phoenix, AZ 85014-2554 |
Second Address | Phoenix, AZ 85014-2554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2017 |
Last Update Date | 26/07/2017 |