Individual provider · NPI-1

Kammna B Farag

Technician/Technologist, Optician · Lakeland, FL

NPI number1992495105
StatusActive
Last updated in NPPESMay 10, 2023

Details

NPI
1992495105
Entity type
Individual (NPI-1)
Name
Kammna B Farag
Sex
Female
Sole proprietor
No
Enumeration date
May 10, 2023
Certification date
May 10, 2023
Last updated
May 10, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, OpticianDO6208FLYes

Practice location

5800 Us Highway 98 N
Lakeland, FL 33809-3110

Phone 863-815-4408 · Fax 863-815-4599

Mailing address

5800 Us Highway 98 N
Lakeland, FL 33809-3110

Phone 863-815-4408 · Fax 863-815-4599

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