Doctor Name: | LORI KAY EGEBERG |
NPI Number: | 1851768261 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DISPENSING OPTICIAN |
License Number: | |
Business Practice Address: | 511 6th St Brookings, SD - 570061436 |
Business Phone Number: | 6056925600 |
Business Fax Number: | 6056925660 |
Mailing Address: | 511 6th St, BROOKINGS |
State: | SD |
Postal Code: | 570061436 |
Phone Number: | 6056925600 |
Fax Number: | 6056925660 |
NPI Enumeration Date: | 09/01/2015 |
NPI Last Update Date: | 09/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156F00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A broad category grouping different kinds of technologists and technicians. See individual definitions. |