Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | TN3492 | TN |
NPI | 1184100935 |
---|---|
Provider Name | Yueren Wang |
First Address | Memphis, TN 38104-2211 |
Second Address | Memphis, TN 38104-2211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2018 |
Last Update Date | 16/07/2018 |