Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | APPLY | AL |
NPI | 1184105652 |
---|---|
Provider Name | Ms. Alyson Tudong Nguyen |
First Address | Montgomery, AL 36117-6983 |
Second Address | Montgomery, AL 36107-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2018 |
Last Update Date | 23/08/2018 |