Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FC0801X | Contact Lens Fitter |
NPI | 1457447930 |
---|---|
Provider Name | Sandra Renee Albert |
First Address | Salem, OR 97306-9427 |
Second Address | Salem, OR 97306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 16/07/2007 |