Individual
JOELLE HOLLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
170 WESTFALEN TRL, MEDINA, MN 55340-4621
(763) 478-3505
Mailing address
170 WESTFALEN TRL, MEDINA, MN 55340-4621
(763) 478-3505
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3470
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063860997
—
MN
Enumeration date
06/01/2016
Last updated
09/20/2018
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