Individual
KATHERINE MARIE MEHALIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG003590
PA
207W00000X
Ophthalmology Physician
OEG003590
PA
390200000X
Student in an Organized Health Care Education/Training Program
OEG003590
PA
Other
Enumeration date
12/05/2019
Last updated
09/28/2021
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