Organization
VAN BUREN OPTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY J VANBUREN MD (OWNER)
(602) 995-1166
Entity
Organization
Contact information
Practice address
1130 E MISSOURI AVE STE 110, PHOENIX, AZ 85014-2712
(602) 995-1166
(602) 995-2390
Mailing address
1130 E MISSOURI AVE STE 110, PHOENIX, AZ 85014-2712
(602) 995-1166
(602) 995-2390
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
05/31/2017
Last updated
05/31/2017
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