Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 731 | AZ |
NPI | 1073766937 |
---|---|
Provider Name | Lyn M Karberg |
First Address | Phoenix, AZ 85012-1839 |
Second Address | Phoenix, AZ 85012-1839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2008 |
Last Update Date | 23/10/2008 |