Individual
DR. TIMOTHY R LANDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
559 VINCENT ST BLDG 959, PETERSON AFB, CO 80914-1541
(702) 653-3010
(702) 653-3023
Mailing address
1895 NATURE PARK DR, NORTH LAS VEGAS, NV 89084-3151
(270) 319-8784
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1322 DT
KY
152W00000X
Optometrist
Primary
1O73-OD
WV
Other
Enumeration date
08/16/2005
Last updated
01/26/2022
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