Individual
COLLEEN ITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
160 S VALENCIA BLVD STE B, WOODLAKE, CA 93286-1712
(559) 564-2020
Mailing address
160 S VALENCIA BLVD STE B, WOODLAKE, CA 93286-1712
(559) 564-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9267
CA
Other
Enumeration date
09/08/2009
Last updated
02/04/2010
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