Provider Demographics
NPI:1891145512
Name:HOLLOP, ANTONIN (OD)
Entity Type:Individual
Prefix:
First Name:ANTONIN
Middle Name:
Last Name:HOLLOP
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:HOLLOP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11 N WILLARD ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-3495
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 N WILLARD ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3495
Practice Address - Country:US
Practice Address - Phone:802-862-3223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT030.0121226152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist