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Organization

DR. ROBERT BASTAICH & ASSOC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT BASTAICH O.D. (OPTOMETRIST)
(804) 320-9457
Entity
Organization

Contact information

Practice address
2501 SHEILA LN, RICHMOND, VA 23225-2041
(804) 320-9457
(804) 320-9458
Mailing address
2501 SHEILA LN, RICHMOND, VA 23225-2041
(804) 320-9457
(804) 320-9458

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0618001635
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1609808880
VA
Enumeration date
08/30/2007
Last updated
08/30/2007
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