East Mountain Eye Clinic PC

NPI #1215927215 in Edgewood, New Mexico

Provider Information

NPI Number: 1215927215
Entity Type: Organization
Organization Name: East Mountain Eye Clinic PC
Primary Specialty: Optometrist
Enumeration Date: Oct 21, 2005
Last Updated: Oct 6, 2008

Practice Location

Address: 1917 OLD ROUTE 66, EDGEWOOD PLAZA
Address 2: SUITE D-1
City: Edgewood
State: New Mexico
ZIP Code: 87015
Phone: (505) 286-2020

Authorized Official

Name: DR. PATRIA DULCE WALKER, O.D.
Title: PRESIDENT
Phone: (505) 286-2020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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