Organization
COOS EYE CENTERS, INC.
Active
Other names
Bandon Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE RUSH ERENFELD O.D. (OWNER)
(541) 347-3622
Entity
Organization
Contact information
Practice address
1095 ALABAMA AVENUE, BANDON, OR 97411
(541) 347-3622
(541) 347-2872
Mailing address
PO BOX 956, BANDON, OR 97411-0956
(541) 347-3622
(541) 347-2872
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2856ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287009
—
OR
Enumeration date
08/06/2007
Last updated
08/06/2007
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