Organization
BLAKE BUSH FAMILY EYECARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAKE ROBERT BUSH O.D. (OWNER)
(580) 223-7333
Entity
Organization
Contact information
Practice address
908 N ROCKFORD RD, SUITE E, ARDMORE, OK 73401-2540
(580) 223-7333
Mailing address
908 N ROCKFORD RD, SUITE E, ARDMORE, OK 73401-2540
(580) 223-7333
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2550
OK
Other
Enumeration date
06/20/2012
Last updated
02/06/2015
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