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Organization

CLIFFORD L. HOLT, O.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JULIE S HOLT (OFFICE MANAGER)
(913) 631-6959
Entity
Organization

Contact information

Practice address
6435 NIEMAN RD, SHAWNEE, KS 66203-3325
(913) 631-6959
(931) 631-5930
Mailing address
6435 NIEMAN RD, SHAWNEE, KS 66203-3325
(913) 631-6959
(931) 631-5930

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
KS12613
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100218370A
KS
Enumeration date
03/04/2008
Last updated
04/27/2012
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