Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FX1101X | Ophthalmic Assistant | 197849 |
NPI | 1205188117 |
---|---|
Provider Name | Jessica Elizabeth Bowling |
First Address | Dayton, OH 45409-1962 |
Second Address | Dayton, OH 45409-1962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2012 |
Last Update Date | 03/10/2012 |