Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 5786 | OH |
NPI | 1013170380 |
---|---|
Provider Name | Mrs. Ame Nicole Cline |
First Address | Dublin, OH 43017-9000 |
Second Address | Dublin, OH 43017-9000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 21/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CL4245271 | (02) | OH |