Individual
ELLEN TALBOTT VAN NORMAN
Active
Individual
ELLEN TALBOTT VAN NORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
6581
OH
152WP0200X
Pediatric Optometrist
Primary
2103DT
KY
Other
Enumeration date
07/17/2017
Last updated
11/16/2021
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