Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1104972686 |
---|---|
Provider Name | Victoria L Crouse |
First Address | Gettysburg, PA 17325-8549 |
Second Address | Gettysburg, PA 17325-8549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 06/05/2009 |