Individual
MISS KIMBERLY CARLA HAERTL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5301 RAVENSDALE LN, AUSTIN, TX 78723-4032
(512) 220-3476
Mailing address
5301 RAVENSDALE LN, AUSTIN, TX 78723-4032
(512) 220-3476
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
ABOC
TX
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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