Individual
DR. HOLLY LEE HANBAUM
Active
Individual
DR. HOLLY LEE HANBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
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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