Organization
SAN TAN EYE CARE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK L HOSTETLER OP (MEMBER)
(480) 807-0288
Entity
Organization
Contact information
Practice address
2680 S VAL VISTA DR, 11, GILBERT, AZ 85295-2152
(480) 807-0288
Mailing address
2680 S VAL VISTA, 111, GILBERT, AZ 85295-1606
(480) 807-0288
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
349
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T41753
UPIN
AZ
Enumeration date
07/01/2008
Last updated
07/01/2008
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