Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 3322S | OH |
NPI | 1154473528 |
---|---|
Provider Name | Ms. Kimberley Lynn Alderman |
First Address | Dayton, OH 45420-2840 |
Second Address | Dayton, OH 45409-2698 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 08/07/2007 |