Individual
JULIANA POSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
5695 HIGHWAY 95 N, LAKE HAVASU CITY, AZ 86404-9646
(928) 764-3755
Mailing address
5695 HIGHWAY 95 N, LAKE HAVASU CITY, AZ 86404-9646
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
003218
AZ
Other
Enumeration date
05/29/2023
Last updated
05/29/2023
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