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NPI Code Detail

MEDICARE: BREWER VISION CENTER

MEDICARE: BREWER VISION CENTER
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
1152W00000XOptometrist1917DTKY

General Provider Information

NPI Number : 1801228978
Entity Type Code : Organization
Provider Name (Legal Business Name) : BREWER VISION CENTER
Provider Business Mailing Address
First Line : 14800 FORT CAMPBELL BLVD
Second Line :
City : OAK GROVE
State : KY
Zip : 42262-8304
Country : US
Telephone Number : 270-640-7670
Fax Number :
Provider Business Practice Location Address
First Line : 14800 FORT CAMPBELL BLVD
Second Line :
City : OAK GROVE
State : KY
Zip : 42262-8304
Country : US
Telephone Number : 270-640-7670
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. LANDON BREWER
Credential : O.D.
Telephone Number : 270-640-7670
Provider Enumeration Date : 07/31/2013
Last Update Date : 08/24/2013

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Directions to “BREWER VISION CENTER ” Practice Location

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