Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 0618002480 | VA |
N | 152W00000X | Optometrist | 6049 | OH |
NPI | 1003194028 |
---|---|
Provider Name | Dr. Katy Bice |
First Address | Virginia Beach, VA 23460-2177 |
Second Address | Virginia Beach, VA 23460-2177 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2011 |
Last Update Date | 27/02/2017 |