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Individual

DR. LINDSEY MICHELLE CLYDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1111 E NORTHERN AVE, SUITE B, PHOENIX, AZ 85020-4188
(602) 242-6888
(602) 242-4654
Mailing address
1111 E NORTHERN AVE, SUITE B, PHOENIX, AZ 85020-4188
(602) 242-6888
(602) 242-4654

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1522
AZ
152W00000X
Optometrist
2497
CO
152WP0200X
Pediatric Optometrist
1522
AZ
152WP0200X
Pediatric Optometrist
2497
CO
152WS0006X
Sports Vision Optometrist
1522
AZ
152WS0006X
Sports Vision Optometrist
2497
CO
156FC0801X
Contact Lens Fitter
1522
AZ

Other

Enumeration date
03/24/2006
Last updated
07/02/2014
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