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Organization

CHARLES A BRIZIUS OD INC

Active
Other names
Brizius and Embry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STACEY O EMBRY OD (SEC/TREAS)
(812) 477-8696
Entity
Organization

Contact information

Practice address
2700 LINCOLN AVE, EVANSVILLE, IN 47714-1628
(812) 477-8696
(812) 477-1874
Mailing address
2700 LINCOLN AVE, EVANSVILLE, IN 47714-1628
(812) 477-8696
(812) 477-1874

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
56000053A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
56000053A
CORPORATION REGISTRATION
IN
Enumeration date
12/14/2005
Last updated
01/20/2011
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