Individual
DR. NISHA PRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1384 TOWNE SQUARE BLVD NW, ROANOKE, VA 24012-1611
(540) 278-2880
Mailing address
5323 MOUNT VIEW RD, ANTIOCH, TN 37013-2308
(615) 731-8900
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT3271
TN
Other
Enumeration date
11/19/2014
Last updated
02/29/2016
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