Dennis M Brtva

NPI #1336112804 in Peoria, Illinois

Provider Information

NPI Number: 1336112804
Entity Type: Organization
Organization Name: Dennis M Brtva
Primary Specialty: Optometrist
Enumeration Date: Feb 7, 2006
Last Updated: Jan 2, 2008

Practice Location

Address: 801 W LAKE AVE
Address 2: 300 EVERGREEN SQUARE
City: Peoria
State: Illinois
ZIP Code: 61614-5951
Phone: (309) 686-0763

Authorized Official

Name: DR. DENNIS M BRTVA, O.D.
Title: OWNER
Phone: (309) 663-2211

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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