Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1700X | Ocularist | 16-375-22 | IA |
NPI | 1275068934 |
---|---|
Provider Name | Lindsey Kazanovicz Boyle |
First Address | Bedford, NH 03110-6971 |
Second Address | Bedford, NH 03110-6971 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2017 |
Last Update Date | 01/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16-375-22 | NATIONAL EXAMINING BOARD OF OCULARIST (01) | NH |