Healthcare Provider Details

I. General information

NPI: 1801109103
Provider Name (Legal Business Name): REBEKAH D BRETZ O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBEKAH D KARR O.D.

II. Dates (important events)

Enumeration Date: 07/15/2010
Last Update Date: 06/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 GARRISON ST SUITE E
LAKEWOOD CO
80215-5881
US

IV. Provider business mailing address

7437 VILLAGE SQUARE DR #115
CASTLE PINES CO
80108-4600
US

V. Phone/Fax

Practice location:
  • Phone: 303-232-0200
  • Fax: 303-232-4044
Mailing address:
  • Phone: 303-688-5066
  • Fax: 303-688-6986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2788
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number13982
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: