Individual
MRS. LISA ELLEN RUBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
S4508
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4360507
—
OH
Enumeration date
09/19/2013
Last updated
09/19/2013
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