Organization
HAL W BREEDLOVE OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAL W BREEDLOVE OD (OPTOMETRIST/OWNER)
(757) 426-2020
Entity
Organization
Contact information
Practice address
1729 WILDWOOD DR, SUITE 101, VIRGINIA BEACH, VA 23454-3176
(757) 426-2020
(757) 481-1964
Mailing address
1729 WILDWOOD DRIVE, SUITE 101, VIRGINIA BEACH, VA 23454
(757) 426-2020
(757) 481-1964
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000633
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679505861
—
VA
Enumeration date
07/08/2006
Last updated
11/28/2012
Update your record
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