Individual
DR. STEPHANIE WOO
Active
Sole proprietor
No
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
(928) 680-1144
(928) 680-8639
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1812
AZ
152W00000X
Optometrist
2011019156
MO
152WC0802X
Corneal and Contact Management Optometrist
2011019156
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922396076
—
MO
Enumeration date
07/11/2011
Last updated
07/15/2020
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