Individual
LEAH MARIE COLLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3425 W PEORIA AVE, PHOENIX, AZ 85029-4606
(602) 504-2720
Mailing address
7455 N 95TH AVE APT 1336, GLENDALE, AZ 85305-1357
(218) 556-6984
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2184
AZ
Other
Enumeration date
06/21/2017
Last updated
07/13/2017
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