Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | 1101004014 | VA |
N | 156FC0801X | Contact Lens Fitter | 1101004014 | VA |
Y | 156FX1800X | Optician | 1101004014 | VA |
NPI | 1619369923 |
---|---|
Provider Name | June Harriette Suggs Rogers |
First Address | Chesapeake, VA 23321-1985 |
Second Address | Chesapeake, VA 23321-1985 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2015 |
Last Update Date | 23/02/2015 |