Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | DIO-434 | HI |
N | 156FC0801X | Contact Lens Fitter | CL8116 | CA |
N | 156FC0801X | Contact Lens Fitter | OP.017041-SC | OH |
N | 156FX1800X | Optician | DIO-434 | HI |
Y | 156FX1800X | Optician | OP.017041-SC | OH |
N | 156FX1800X | Optician | SL40477 | CA |
NPI | 1740661347 |
---|---|
Provider Name | Mrs. Bonnie J Ashley |
First Address | Oakwood, OH 45419-1552 |
Second Address | Oakwood, OH 45419-1552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2015 |
Last Update Date | 29/08/2018 |