Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT.0003494 | CO |
NPI | 1013578707 |
---|---|
Provider Name | Lindsey Grace Holland |
First Address | Denver, CO 80212-2452 |
Second Address | Northglenn, CO 80234-4124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2019 |
Last Update Date | 24/06/2019 |