Organization
SOMERTON EYECARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY M DE LA VARA (LICENSED OPTICIAN)
(928) 627-4525
Entity
Organization
Contact information
Practice address
725 E. MAIN ST., SUITE 1C, SOMERTON, AZ 85350-0634
(928) 627-4525
Mailing address
PO BOX 634, SOMERTON, AZ 85350-0634
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1210
AZ
Other
Enumeration date
02/20/2007
Last updated
08/20/2013
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