Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | S2805 | OH |
NPI | 1033137195 |
---|---|
Provider Name | Elaine R Noe |
First Address | Wadsworth, OH 44281-9482 |
Second Address | Wadsworth, OH 44281-9482 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 22/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0765266 | (05) | OH |