Organization
CLIFFORD L. HOLT, O.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE S. HOLT (VICE PRESIDENT)
(913) 631-6959
Entity
Organization
Contact information
Practice address
6435 NIEMAN RD, SHAWNEE, KS 66203-3325
(913) 631-6959
(913) 631-5930
Mailing address
6435 NIEMAN RD, SHAWNEE, KS 66203-3325
(913) 631-6959
(913) 631-5930
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1261-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100218370C
—
KS
Enumeration date
03/20/2012
Last updated
03/30/2012
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