Individual
MRS. BRENDA M HOPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED OPTICIAN
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
S-6587
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27-3752924
ANTHEM
OH
Enumeration date
05/02/2011
Last updated
05/02/2011
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