Individual
ELENA FILATOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D
Contact information
Practice address
1423 S HIGLEY RD STE 104, MESA, AZ 85206-3449
(480) 985-0086
(480) 985-2153
Mailing address
1423 S HIGLEY RD. SUITE 104, MESA, AZ 85206
(480) 985-0086
(480) 985-2153
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1936
AZ
152W00000X
Optometrist
638
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24986348
—
NM
01
—
638
LICENSE - OPTOMETRY
NM
Enumeration date
09/20/2011
Last updated
05/15/2017
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