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General NPI Number Information
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NPI Number | 1801176177
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Entity Type | Organization
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Legal Business Name | POTEAU EYE CARE LLC
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Dates
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Enumeration Date | 08/18/2011
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1230 S BROADWAY AVE
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City | POTEAU
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State | OK
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Zip | 74953-5266
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Country | US
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Telephone | 918-906-0316
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 490
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City | POTEAU
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State | OK
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Zip | 74953-0490
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Country | US
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Telephone | 918-647-2153
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Fax | 918-647-8711
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANGELA BREEDING
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Credential | O.D.
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Telephone | 918-647-2153
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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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