Organization
PRIMERA ENTERPRISE LLC
Active
Other names
Primera Vista Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MAYRA MACHUCA (OPTICIAN)
(623) 877-2481
Entity
Organization
Contact information
Practice address
2950 N 91ST AVE STE C-102, PHOENIX, AZ 85037-3380
(623) 877-2481
Mailing address
2950 N 91ST AVE STE C-102, PHOENIX, AZ 85037-3380
(623) 877-2481
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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