Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 12529 | CA |
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 775 | SD |
NPI | 1235345653 |
---|---|
Provider Name | Melanie Louise Culvey |
First Address | Rapid City, SD 57701-6111 |
Second Address | Rapid City, SD 57701-6111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 23/10/2021 |