Organization
BUENA VISTA OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WAYNE TINKER LICENSED OPTICIAN (MANAGER)
(602) 285-9215
Entity
Organization
Contact information
Practice address
300 E OSBORN RD, SUITE 100, PHOENIX, AZ 85012-2325
(602) 285-9215
Mailing address
300 E OSBORN RD, SUITE 100, PHOENIX, AZ 85012-2325
(602) 285-9215
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1067E
AZ
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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