Provider Demographics
NPI:1154390839
Name:HOLLAND, BRIAN CHARLES (OD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHARLES
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2179 S MOONEY BLVD
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-6242
Mailing Address - Country:US
Mailing Address - Phone:559-732-2291
Mailing Address - Fax:559-732-6955
Practice Address - Street 1:2179 S MOONEY BLVD
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-6242
Practice Address - Country:US
Practice Address - Phone:559-732-2291
Practice Address - Fax:559-732-6955
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11425T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist