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General NPI Number Information
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NPI Number | 1487837654
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Entity Type | Organization
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Legal Business Name | AZ EYE HEALTH PLLC
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 11/12/2008
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Provider Practice Location Address
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Address Line | 8575 E PRINCESS DR #105
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-5483
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Country | US
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Telephone | 480-585-0001
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Fax | 480-585-0760
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Provider Business Mailing Address
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Address Line | 8575 E PRINCESS DR #105
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-5483
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Country | US
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Telephone | 480-585-0001
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Fax | 480-585-0760
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Authorized Official
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Title or Position | OPTOMETRIST/ OWNER
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Name | DR. BRETT K GRAMLICH
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Credential | O.D
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Telephone | 480-585-0001
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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 | 1105
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1049
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License Number State | AZ
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