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General NPI Number Information
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NPI Number | 1891963203
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Entity Type | Individual
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Provider Name | LYNN E PERKINS GLANCY OPTICIAN NCLC
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Gender | Female
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 300 E OSBORN
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City | PHY
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State | AZ
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Zip | 85012
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Country | US
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Telephone | 602-277-3152
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Fax | 602-234-1552
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Provider Business Mailing Address
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Address Line | 300 E OSBORN SUITE 201
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City | PHOENIX
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State | AZ
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Zip | 85012
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Country | US
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Telephone | 602-277-3152
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Fax | 602-234-1552
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FC0801X
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Taxonomy Name | Contact Lens Fitter
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License Number | 613
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License Number State | AZ
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