Provider Demographics
NPI:1245023936
Name:CARLSON, HOLLY GRACE (OD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:GRACE
Last Name:CARLSON
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 1:1872 DEEPWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-4661
Mailing Address - Country:US
Mailing Address - Phone:815-322-3020
Mailing Address - Fax:
Practice Address - Street 1:215 W BOWERY ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1069
Practice Address - Country:US
Practice Address - Phone:330-543-5290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.007380152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist