Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OET009008 | PA |
NPI | 1184887184 |
---|---|
Provider Name | Melissa Nielsen Rost |
First Address | Ligonier, PA 15658-2489 |
Second Address | Greensburg, PA 15601-1290 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 09/07/2008 |