Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1101002394 | VA |
NPI | 1043240740 |
---|---|
Provider Name | Lang X Bell |
First Address | Virginia Beach, VA 23464-3803 |
Second Address | Virginia Beach, VA 23464-3803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 10/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
121833001 | (05) | VA |