Provider Demographics
NPI:1275919615
Name:GREITEN, LINDSAY (OD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:GREITEN
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 1:525 W WETMORE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-5093
Mailing Address - Country:US
Mailing Address - Phone:520-293-2363
Mailing Address - Fax:520-293-0475
Practice Address - Street 1:525 W WETMORE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-5093
Practice Address - Country:US
Practice Address - Phone:520-293-2363
Practice Address - Fax:520-293-0475
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2082152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist