MEDICARE: BRETT JAMAS HYTREK O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1337	NE

General Provider Information

NPI Number	:	1184954927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT JAMAS HYTREK O.D.

Provider Business Mailing Address
First Line	:	503 MCMILLAN ST
Second Line	:
City	:	HOLDREGE
State	:	NE
Zip	:	68949-2052
Country	:	US
Telephone Number	:	308-995-8697
Fax Number	:

Provider Business Practice Location Address
First Line	:	503 MCMILLAN ST
Second Line	:
City	:	HOLDREGE
State	:	NE
Zip	:	68949-2052
Country	:	US
Telephone Number	:	308-995-8697
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2009
Last Update Date	:	12/29/2009

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