Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | 213274 | PA |
Y | 156FX1800X | Optician | 213274 | PA |
NPI | 1568814267 |
---|---|
Provider Name | William Bips |
First Address | Plymouth Meeting, PA 19462-2449 |
Second Address | Plymouth Meeting, PA 19462-2449 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2016 |
Last Update Date | 06/07/2016 |