Blake Bush Family Eyecare Inc.

NPI 1043573470 - Optometrist - 152W00000X

NPI Details
NPI 1043573470
Enumeration Date 06/20/2012
Last Updated 02/06/2015
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name BLAKE ROBERT BLAKE
Position OWNER
Phone (580) 223-7333
Fax
Practice Location
908 N ROCKFORD RD
SUITE E
ARDMORE OK, 73401-2540, US
Phone (580) 223-7333
Fax
Business Location
908 N ROCKFORD RD
SUITE E
ARDMORE OK, 73401-2540, US
Phone (580) 223-7333
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Oklahoma
License Number 2550
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According to our database, Blake Bush Family Eyecare Inc. NPI is 1043573470, taxonomy code is 152W00000X and license number is 2550, license state is located at Oklahoma. Blake Bush Family Eyecare Inc. physically located at 908 N Rockford Rd, Ardmore OK, 73401-2540. NPI Number 1033115704 has the healthcare provider type.

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1043573470 NPI number is provided on an as is basis without warranty of any kind. 1043573470 is maintained by the National Plan & Provider Enumeration System. The contents of Blake Bush Family Eyecare Inc. are for informational purposes only.