Doctor Name: | AMANDA TAYLOR |
NPI Number: | 1225412026 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OPTOMETRY TECH |
License Number: | |
Business Practice Address: | Bldg 301 Andrews Avenue Lyster Army Health Clinic Fort Rucker, AL - 363625333 |
Business Phone Number: | 3342557185 |
Business Fax Number: | |
Mailing Address: | Bldg 301 Andrews Avenue, Lyster Army Health Clinic FORT RUCKER |
State: | AL |
Postal Code: | 363625333 |
Phone Number: | 3342557185 |
Fax Number: | |
NPI Enumeration Date: | 07/13/2015 |
NPI Last Update Date: | 07/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1202X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optometric Technician |
Taxonomy Definition: |