Provider Demographics
NPI:1013578707
Name:HOLLAND, LINDSEY GRACE (OD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:GRACE
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4390 TENNYSON ST APT 201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-2452
Mailing Address - Country:US
Mailing Address - Phone:210-296-9233
Mailing Address - Fax:
Practice Address - Street 1:10465 MELODY DR STE 111
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-4124
Practice Address - Country:US
Practice Address - Phone:303-252-9981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003494152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist