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Individual

DR. ADAM BRYCE BLACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D., M.S.

Contact information

Practice address
5865 W UTOPIA RD, GLENDALE, AZ 85308-5251
(623) 572-3919
Mailing address
5865 W UTOPIA RD, GLENDALE, AZ 85308-5251
(623) 572-3919

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1710
AZ
152W00000X
Optometrist
ODP-100258
ID

Other

Enumeration date
08/11/2009
Last updated
08/19/2015
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