Organization
BLUEGRASS VISION GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN E COLEMAN OD (OWNER)
(859) 498-4800
Entity
Organization
Contact information
Practice address
25 STERLING WAY, SUITE C, MOUNT STERLING, KY 40353-1174
(859) 498-4800
(859) 498-2021
Mailing address
25 STERLING WAY, SUITE C, MOUNT STERLING, KY 40353-1174
(859) 498-4800
(859) 498-2021
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100463130
—
KY
Enumeration date
09/06/2016
Last updated
01/08/2019
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