Provider Demographics
NPI:1396125837
Name:HOLLAND, ZACHARY ROBERT (OD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:ROBERT
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:ZAC
Other - Middle Name:ROBERT
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:5201 EDEN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-2359
Mailing Address - Country:US
Mailing Address - Phone:952-300-2151
Mailing Address - Fax:952-657-5745
Practice Address - Street 1:5201 EDEN AVE STE 150
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55436-2359
Practice Address - Country:US
Practice Address - Phone:952-300-2151
Practice Address - Fax:952-657-5745
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3426152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist