Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 0618000384 | VA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 0618000384 | VA |
NPI | 1083888333 |
---|---|
Provider Name | Dr. Marsha C Gage |
First Address | Hamilton, VA 20158-3543 |
Second Address | Leesburg, VA 20176-3318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2008 |
Last Update Date | 17/04/2008 |