NPI | 1982654612 |
---|---|
Former Name | HOLLY LYNN ZEMLICKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP-1027) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: ID ODP-1027) |
152WP0200X Optometrist, Pediatrics (Licence: ID ODP-1027) | |
152WS0006X Optometrist, Sports Vision (Licence: ID ODP-1027) | |
Enumeration Date | 2006-05-11 |
Last Update Date | 2008-02-18 |