Individual
KELLY LYN CHASNOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15245 S TAMIAMI TRL STE 6, FORT MYERS, FL 33908-4596
(239) 405-0346
Mailing address
15245 S TAMIAMI TRL STE 6, FORT MYERS, FL 33908-4596
(239) 405-0346
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
4828
FL
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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