Individual
COLLEEN ANNALINA TEJCHMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
383 LAKE HAVASU AVE S, LAKE HAVASU CITY, AZ 86403-9368
(928) 680-1144
(928) 680-8639
Mailing address
383 LAKE HAVASU AVE S, LAKE HAVASU CITY, AZ 86403-9368
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3100
OK
152W00000X
Optometrist
OPT-002492
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2020
Last updated
12/01/2022
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