Doctor Name: | SANDY YARRA |
NPI Number: | 1306863485 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1005 Charlevoix Dr Suite 200 Grand Ledge, MI - 488378186 |
Business Phone Number: | 5176273030 |
Business Fax Number: | 5176272020 |
Mailing Address: | 1005 Charlevoix Dr, Suite 200 GRAND LEDGE |
State: | MI |
Postal Code: | 488378186 |
Phone Number: | 5176273030 |
Fax Number: | 5176272020 |
NPI Enumeration Date: | 07/16/2006 |
NPI Last Update Date: | 05/06/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |