Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | S11430 | OH |
NPI | 1215320809 |
---|---|
Provider Name | Sabina Lewis |
First Address | Columbus, OH 43240-2024 |
Second Address | Columbus, OH 43240-2024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2015 |
Last Update Date | 06/03/2015 |