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Individual

KATHIE JOY CRISP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LDO

Contact information

Practice address
2767 U.S. HIGHWAY 90 WEST, LAKE CITY, FL 32055
(386) 755-3136
(386) 755-4816
Mailing address
2767 U.S. HIGHWAY 90 WEST, LAKE CITY, FL 32055
(386) 755-3136
(386) 755-4816

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO5913
FL

Other

Enumeration date
05/19/2023
Last updated
05/19/2023
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