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General NPI Number Information
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NPI Number | 1174888770
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Entity Type | Organization
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Legal Business Name | MILLBROOK EYE CARE LLC
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 3331 HIGHWAY 14
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City | MILLBROOK
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State | AL
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Zip | 36054-1838
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Country | US
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Telephone | 334-285-4828
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Fax | 334-285-4881
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Provider Business Mailing Address
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Address Line | 3331 HIGHWAY 14
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City | MILLBROOK
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State | AL
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Zip | 36054-1838
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Country | US
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Telephone | 334-285-4828
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Fax | 334-517-4341
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Authorized Official
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Title or Position | OWNER
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Name | BRYAN TRUETT HOLMAN
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Credential | OD
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Telephone | 334-403-2005
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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 | S-B81-TA-793
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License Number State | AL
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