Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | S4198 | OH |
NPI | 1053694026 |
---|---|
Provider Name | Sandra K Mcharg-Bevins |
First Address | Columbus, OH 43229-1012 |
Second Address | Columbus, OH 43229-1012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2011 |
Last Update Date | 26/09/2011 |