=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184806895
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CATHERINE HOLLENBACH, OD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2007
-----------------------------------------------------
Last Update Date | 08/04/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14275 N. 87TH ST. SUITE 112
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85260-3696
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-970-4333
-----------------------------------------------------
Fax | 480-538-5143
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14275 N 87TH ST SUITE 112
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85260-3696
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-970-4333
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. CATHERINE A HOLLENBACH
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 480-970-4333
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 972
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------