| Doctor Name: | MS. SALLY D. ELKINS |
| NPI Number: | 1497972657 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LDO |
| License Number: | 171 |
| Business Practice Address: | 2989 Shelburne Rd Ste 1 Shelburne, VT - 054826369 |
| Business Phone Number: | 8029858333 |
| Business Fax Number: | 8029855770 |
| Mailing Address: | 2989 Shelburne Rd Ste 1, SHELBURNE |
| State: | VT |
| Postal Code: | 054826369 |
| Phone Number: | 8029858333 |
| Fax Number: | 8029855770 |
| NPI Enumeration Date: | 04/19/2007 |
| NPI Last Update Date: | 09/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 171 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |