Provider Demographics
NPI:1689992653
Name:VINCENT, HOLLY (OD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:VINCENT
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:PO BOX 1530
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80402-1530
Mailing Address - Country:US
Mailing Address - Phone:303-420-0900
Mailing Address - Fax:303-420-0236
Practice Address - Street 1:5195 WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-4617
Practice Address - Country:US
Practice Address - Phone:303-420-0900
Practice Address - Fax:303-420-0236
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2675152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist