Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | SA04TA-552 | AL |
NPI | 1013000595 |
---|---|
Provider Name | Wendy Jeanette Cummings |
First Address | Sterrett, AL 35147 |
Second Address | Alexander City, AL 35010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |