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Organization

BREIWA WARE & JESKIE PSC

Active
Other names
Vison Source of Bowling Green
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN N. BREIWA O.D. (PRESIDENT)
(270) 842-0383
Entity
Organization

Contact information

Practice address
335 NEW TOWNE RD, BOWLING GREEN, KY 42103-7966
(270) 842-0383
(270) 842-0485
Mailing address
P.O. BOX 5000, 335 NEW TOWNE DRIVE, BOWLING GREEN, KY 42103-7966
(270) 842-0383
(270) 842-0485

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
332H00000X
Eyewear Supplier

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06622
SPECTERA
KY
05
7100253310
KY
Enumeration date
02/12/2007
Last updated
09/21/2018
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