Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1101X | Ophthalmic Assistant |
NPI | 1558708289 |
---|---|
Provider Name | Miss Amy Kay Kanour |
First Address | Bonita Springs, FL 34136-6550 |
Second Address | Lewisburg, PA 17837-1944 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2013 |
Last Update Date | 04/06/2013 |