Individual
CHELSIA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
HOSPITAL DRIVE OFF HIGHWAY 191, CHINLE, AZ 86503-8000
(928) 674-7160
Mailing address
PO BOX PH, CHINLE, AZ 86503-8000
(928) 674-7160
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14452
CA
Other
Enumeration date
06/22/2012
Last updated
02/11/2022
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