Organization
TIBURON FAMILY EYECARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY J CARPENTER (OWNER/OPTOMETRIST)
(402) 933-5775
Entity
Organization
Contact information
Practice address
11314 WICKERSHAM BLVD, STE. 300, GRETNA, NE 68028-6989
(402) 933-5775
Mailing address
11314 WICKERSHAM BLVD, STE. 300, GRETNA, NE 68028-6989
(402) 933-5775
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1277
NE
Other
Enumeration date
01/15/2013
Last updated
04/17/2013
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