Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1215363346 |
---|---|
Provider Name | Robert James Frank |
First Address | Laporte, CO 80535-1411 |
Second Address | Loveland, CO 80538-2459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2013 |
Last Update Date | 20/09/2013 |