Individual
JAMES REVENNAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
86 PONCE DE LEON BLVD, BROOKSVILLE, FL 34601-2818
(352) 796-2141
Mailing address
14073 SNOW MEMORIAL HWY, BROOKSVILLE, FL 34601-4466
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 4450
FL
Other
Enumeration date
08/27/2009
Last updated
06/16/2010
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