Individual
JACOB RICHARD BROMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
725 E MAIN ST, APT #1C, SOMERTON, AZ 85350
(928) 627-4525
Mailing address
17439 N 57TH AVE, GLENDALE, AZ 85308-3819
(925) 708-5301
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002462
AZ
Other
Enumeration date
09/11/2020
Last updated
02/25/2021
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