Organization
STACIE L WESTEN OD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACIE WESTEN (PRESIDENT)
(623) 824-4351
Entity
Organization
Contact information
Practice address
5605 W NORTHERN AVE, GLENDALE, AZ 85301-1332
(623) 934-6917
Mailing address
5122 E SHEA BLVD, APT. 1088, SCOTTSDALE, AZ 85254-4622
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1456
AZ
Other
Enumeration date
10/19/2006
Last updated
09/25/2009
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