Individual
DR. MICHAEL KOTLICKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
8827 COLUMBIA 100 PKWY STE 3, THE SIGNATURE CENTRE, COLUMBIA, MD 21045-2178
(410) 730-5808
(410) 730-5893
Mailing address
8827 COLUMBIA 100 PKWY STE 3, THE SIGNATURE CENTRE, COLUMBIA, MD 21045-2178
(410) 730-5808
(410) 730-5893
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
TA0750
MD
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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