Individual
MAISHA LANGELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1226 NE 7TH ST, GRANTS PASS, OR 97526-1424
(541) 476-6636
Mailing address
1226 NE 7TH ST, GRANTS PASS, OR 97526-1424
(541) 476-6636
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
662
HI
152W00000X
Optometrist
Primary
AT13587
OR
Other
Enumeration date
04/19/2011
Last updated
11/15/2022
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