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Individual
AMY ELIZABETH COBURN
Active
Individual
AMY ELIZABETH COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1574-607T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185546722
—
AR
05
—
1888982
—
LA
Enumeration date
06/01/2009
Last updated
12/11/2020
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