NPI | 1134298516 |
---|---|
Former Name | TRACY L HOLLINGSHEAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003198A) |
Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 1646) |
Enumeration Date | 2006-11-07 |
Last Update Date | 2025-08-08 |