Bentonville Eye Care, Pllc

NPI 1083984116 - Optometrist - 152W00000X

NPI Details
NPI 1083984116
Enumeration Date 01/05/2012
Last Updated 01/05/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name DERRICK ALLYN DERRICK
Position MANAGER
Phone (479) 715-6861
Fax (479) 715-6845
Practice Location
800 SE WALTON BLVD
SUITE 12
BENTONVILLE AR, 72712-5376, US
Phone (479) 715-6861
Fax (479) 715-6845
Business Location
800 SE WALTON BLVD
SUITE 12
BENTONVILLE AR, 72712-5376, US
Phone (479) 715-6861
Fax (479) 715-6845
Toxanomy
Taxonomy Code 152W00000X
License State Arkansas
License Number PC-157
Remove 1083984116 NPI Number
 

According to our database, Bentonville Eye Care, Pllc NPI is 1083984116, taxonomy code is 152W00000X and license number is PC-157, license state is located at Arkansas. Bentonville Eye Care, Pllc physically located at 800 Se Walton Blvd, Bentonville AR, 72712-5376. NPI Number 1033115704 has the healthcare provider type.

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1083984116 NPI number is provided on an as is basis without warranty of any kind. 1083984116 is maintained by the National Plan & Provider Enumeration System. The contents of Bentonville Eye Care, Pllc are for informational purposes only.