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Individual

DONNETA MCCANDLESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OPTICIAN

Contact information

Practice address
1403 ANDREA ST, BOWLING GREEN, KY 42104-3335
(270) 651-2181
(270) 651-2183
Mailing address
108 BRAVO BLVD, GLASGOW, KY 42141-3478
(270) 651-2181
(270) 651-2183

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1016
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1016
OPTICIAN LICENSE
KY
Enumeration date
10/25/2005
Last updated
05/12/2011
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