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JACOB RICHARD BROMLEY OD

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1992310312

Individual Registrant:
 JACOB RICHARD BROMLEY OD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
725 E MAIN ST, APT #1C  SOMERTON, AZ 85350 US
Tel: 928-627-4525  Fax: --

Contact information for business:
17439 N 57TH AVE  GLENDALE, AZ 85308-3819 US
Tel: 925-708-5301  Fax: --

Registration Information:
NPI: 1992310312
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
AZ002462

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS AZ - Page 1



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