| NPI | 1699750927 |
|---|---|
| Former Name | STACEY E HOLDSWORTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2934) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AZ 1121) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2021-06-18 |