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General NPI Number Information
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NPI Number | 1003964032
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Entity Type | Organization
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Legal Business Name | HOLLAND EYE CLINIC, P.A.
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 1106 WALNUT ST
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City | OSKALOOSA
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State | KS
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Zip | 66066-4203
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Country | US
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Telephone | 785-863-2000
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Fax | 785-863-3333
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Provider Business Mailing Address
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Address Line | 1106 WALNUT ST
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City | OSKALOOSA
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State | KS
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Zip | 66066-4203
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Country | US
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Telephone | 785-863-2000
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Fax | 785-863-3333
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEANNETTE LORRAINE HOLLAND
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Credential | O.D.
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Telephone | 785-863-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1530CHARLES1446JNETT
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License Number State | KS
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