Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1986 | KS |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | 1986 | KS |
NPI | 1003196882 |
---|---|
Provider Name | Mrs. Annie Marie Mosier Eslit |
First Address | Fort Riley, KS 66442-4030 |
Second Address | Fort Riley, KS 66442-4030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2011 |
Last Update Date | 22/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
KA3592001 | (02) | KS |