Organization
REVOLUTION-EYES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN DOUGLAS OSBORNE O.D. (OWNER)
(509) 771-9342
Entity
Organization
Contact information
Practice address
215 E BROADWAY AVE, MOSES LAKE, WA 98837-1717
(509) 771-9342
(509) 765-0204
Mailing address
215 E BROADWAY AVE, MOSES LAKE, WA 98837-1717
(509) 771-9342
(509) 765-0204
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
602967641
WA
Other
Enumeration date
01/11/2010
Last updated
01/11/2010
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