Organization
THADDEUS W BARTLES OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THADDEUS W. BARTLES O.D. (PRESIDENT)
(860) 582-0702
Entity
Organization
Contact information
Practice address
271 FARMINGTON AVE, BRISTOL, CT 06010-3962
(860) 582-0702
(860) 314-0263
Mailing address
271 FARMINGTON AVE, BRISTOL, CT 06010-3962
(860) 582-0702
(860) 314-0263
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
790
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4021549
—
CT
Enumeration date
04/18/2006
Last updated
02/04/2013
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