Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | 568 | NV |
N | 156FC0801X | Contact Lens Fitter | 568 | NV |
Y | 156FX1800X | Optician | 568 | NV |
NPI | 1063855542 |
---|---|
Provider Name | Wesley T Deputy |
First Address | Carson City, NV 89706-1935 |
Second Address | Carson City, NV 89706-1935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2013 |
Last Update Date | 15/04/2013 |