Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1101003292 | VA |
NPI | 1033295068 |
---|---|
Provider Name | Mrs. Leanne M Perry |
First Address | Norfolk, VA 23505 |
Second Address | Norfolk, VA 23505-2503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 17/03/2018 |