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Organization

PBW OPTOMETRY PC

Active
Other names
Riverview Vision Center
Organization subpart
No

Provider details

NPI number
Authorized official
DOONE BURGENER (BUSINESS MANAGER)
(928) 505-5843
Entity
Organization

Contact information

Practice address
1923 MCCULLOCH BLVD #102, LAKE HAVASU CITY, AZ 86403-6722
(928) 854-3555
(928) 854-4544
Mailing address
1923 MCCULLOCH BLVD #102, LAKE HAVASU CITY, AZ 86403-6722
(928) 854-3555
(928) 854-4544

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1060
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7547290001
MEDICARE NSC
Enumeration date
08/24/2016
Last updated
08/09/2017
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