Organization
BRITT A BUCKLEY MD PC
Active
Other names
Peak Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE GALLIVAN (CREDENTIALING LEAD)
(727) 755-0693
Entity
Organization
Contact information
Practice address
3155 N UNION BLVD, COLORADO SPRINGS, CO 80907-8703
(727) 755-0693
Mailing address
311 PARK PLACE BLVD, SUITE 500, CLEARWATER, FL 33759-4904
(727) 755-0693
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
25358
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45880581
—
CO
Enumeration date
06/07/2016
Last updated
06/07/2016
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