Organization
DR ROBERT D HEAD AND DR JENNIFER L HEAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA BREWSTER (OFFICE MANAGER)
(580) 355-1298
Entity
Organization
Contact information
Practice address
1302 SW C AVE, LAWTON, OK 73501-4243
(580) 355-1298
(580) 581-7201
Mailing address
1302 SW C AVE, LAWTON, OK 73501-4243
(580) 355-1298
(580) 581-7201
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1049
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100763770A
—
OK
Enumeration date
05/15/2007
Last updated
03/08/2012
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