Great Basin Eyecare, Pllc

NPI 1487836151 - Optometrist - 152W00000X

NPI Details
NPI 1487836151
Enumeration Date 12/04/2007
Last Updated 12/04/2007
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name KELLY J KELLY
Position OWNER
Phone (509) 547-6998
Fax (509) 547-6966
Practice Location
9825 SANDIFUR PKWY
SUITE B
PASCO WA, 99301-6738, US
Phone (509) 547-6998
Fax (509) 547-6966
Business Location
PO BOX 4013
PASCO WA, 99302-4013, US
Phone (509) 547-6998
Fax (509) 547-6966
Toxanomy
Taxonomy Code 152W00000X
License State Washington
License Number OD1536TX
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According to our database, Great Basin Eyecare, Pllc NPI is 1487836151, taxonomy code is 152W00000X and license number is OD1536TX, license state is located at Washington. Great Basin Eyecare, Pllc physically located at 9825 Sandifur Pkwy, Pasco WA, 99301-6738. NPI Number 1033115704 has the healthcare provider type.

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1487836151 NPI number is provided on an as is basis without warranty of any kind. 1487836151 is maintained by the National Plan & Provider Enumeration System. The contents of Great Basin Eyecare, Pllc are for informational purposes only.