Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1235436346 |
---|---|
Provider Name | Mandy R Pfeil |
First Address | Oklahoma City, OK 73156-0488 |
Second Address | Oklahoma City, OK 73120-5035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2011 |
Last Update Date | 25/02/2011 |