Organization
MARILYN HOLM
Active
Other names
Holm Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARILYN KAY HOLM O.D. (OWNER)
(316) 209-0142
Entity
Organization
Contact information
Practice address
1320 S COUNTRYWOOD DR, WASILLA, AK 99623-9228
(316) 209-0142
Mailing address
1320 S COUNTRYWOOD DR, WASILLA, AK 99623-9228
(316) 209-0142
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1550
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100346290D
—
KS
01
—
13089
PHS
KS
01
—
2062367
FIRST HEALTH
KS
01
—
39850
FIRSTGUARD
KS
Enumeration date
03/31/2006
Last updated
01/28/2013
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