Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | ||
N | 156FC0801X | Contact Lens Fitter | ||
N | 156FX1202X | Optometric Technician | ||
N | 156FX1800X | Optician |
NPI | 1083978605 |
---|---|
Provider Name | Mrs. Margaret Coffen |
First Address | Minocqua, WI 54548-0182 |
Second Address | Minocqua, WI 54548-0182 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2012 |
Last Update Date | 13/03/2014 |