Individual
EMILY TETZLAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 CAPRI BLVD, LAKE HAVASU CITY, AZ 86403-5661
(928) 855-9477
Mailing address
40 CAPRI BLVD, LAKE HAVASU CITY, AZ 86403-5661
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-002804
AZ
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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