Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1101002935 | VA |
NPI | 1023379658 |
---|---|
Provider Name | Miss Norma Kaye Walker |
First Address | Roanoke, VA 24012-7319 |
Second Address | Roanoke, VA 24012-7319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2012 |
Last Update Date | 30/05/2012 |