Provider Demographics
NPI:1326359886
Name:YOUNG, HOLLY T (OD)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:T
Last Name:YOUNG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MRS
Other - First Name:HOLLY
Other - Middle Name:T
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:790 MONTCLAIR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1966
Mailing Address - Country:US
Mailing Address - Phone:205-592-3911
Mailing Address - Fax:205-592-3537
Practice Address - Street 1:790 MONTCLAIR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1966
Practice Address - Country:US
Practice Address - Phone:205-592-3911
Practice Address - Fax:205-592-3537
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSC39152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist