Individual
LOUCHLYN TREMAINE FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1150 E VINE ST, KISSIMMEE, FL 34744-3579
(312) 972-1765
Mailing address
11954 NARCOOSSEE RD STE 2, PMB 234, ORLANDO, FL 32832-6998
(312) 972-1765
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046.011261
IL
152W00000X
Optometrist
Primary
OPC5686
FL
Other
Enumeration date
11/25/2018
Last updated
09/11/2019
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