Individual
KYLE BETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2254 W INTERNATIONAL SPEEDWAY BLVD, DAYTONA BEACH, FL 32114-1124
(138) 625-2363
Mailing address
3 PRINCE JOHN LN, PALM COAST, FL 32164-7159
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 5258
FL
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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