Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1101X | Ophthalmic Assistant | 97281 | MI |
NPI | 1467644542 |
---|---|
Provider Name | Yvette Marie Zacharias |
First Address | Washington, MI 48094-3536 |
Second Address | Washington, MI 48094-3536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2007 |
Last Update Date | 13/08/2007 |