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General NPI Number Information
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NPI Number | 1124546882
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Entity Type | Organization
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Legal Business Name | BRIDGE HILL EYE, LLC
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 13803 W 82ND TER
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City | LENEXA
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State | KS
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Zip | 66215-4168
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Country | US
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Telephone | 816-533-5336
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Fax |
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Provider Business Mailing Address
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Address Line | 13803 W 82ND TER
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City | LENEXA
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State | KS
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Zip | 66215-4168
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Country | US
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Telephone | 816-533-5336
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MATTHEW COURY BROBERG
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Credential | OD
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Telephone | 816-533-5336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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