DR. Thara Atiyya Bacchus, O.D.

NPI #1093917460 in Clermont, Florida

Provider Information

NPI Number: 1093917460
Entity Type: Individual
Name: DR. Thara Atiyya Bacchus, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Jun 5, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1450 JOHNS LAKE ROAD
City: Clermont
State: Florida
ZIP Code: 34711
Phone: (352) 243-5652

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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