Individual
DR. HOLLY LEE HANBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1010 NORTH 21ST ST, NEWARK, OH 43055-2922
(740) 366-5050
(740) 366-4149
Mailing address
1010 NORTH 21ST ST, NEWARK, OH 43055-2922
(740) 366-5050
(740) 366-4149
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3537T472
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0562850
—
OH
01
—
2267770001
MEDICARE DURABLE
OH
Enumeration date
01/30/2006
Last updated
09/03/2010
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