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NANCY DE LA VARA
Optician >> Technician/Technologist >> Eye and Vision Services ProvidersRegistrant NPI Number: 1790089928
Individual Registrant: NANCY DE LA VARA
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
725 E. MAIN ST. SUITE 1C SOMERTON, AZ 85350-0634 US
Tel: 928-627-4525 Fax: --
Tel: 928-627-4525 Fax: --
Contact information for business:
PO BOX 634 SOMERTON, AZ 85350-0634 US
Tel: 928-627-4525 Fax: --
Tel: 928-627-4525 Fax: --
Registration Information:
NPI: 1790089928
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 156FX1800X | Eye and Vision Services Providers Technician/Technologist Optician | AZ | 2571I |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
