Individual
LEE A FERNHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008896500000
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08100497
—
CO
Enumeration date
11/01/2006
Last updated
10/17/2007
Update your record
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