Individual
KIMBERLY PENIX LAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
601 PROVIDENCE PARK DR E, MOBILE, AL 36695-4617
(251) 650-2020
(251) 650-1010
Mailing address
601 PROVIDENCE PARK DR E, MOBILE, AL 36695-4617
(251) 650-2020
(251) 650-1010
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
00000
GA
152W00000X
Optometrist
3450
MN
152W00000X
Optometrist
Primary
S-D45-TA-975
AL
152W00000X
Optometrist
T-214-TA-975
AL
Other
Enumeration date
04/28/2014
Last updated
02/01/2023
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