Individual
ELYSIA ISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6001
Mailing address
825 POLLARD RD, STE 208, LOS GATOS, CA 95032-1435
(505) 368-6001
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34112TLG
CA
152W00000X
Optometrist
OPT.0003406
CO
Other
Enumeration date
05/31/2018
Last updated
01/08/2020
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