Waterbury Vision Clinic LLC

NPI #1720478514 in Tacoma, Washington

Provider Information

NPI Number: 1720478514
Entity Type: Organization
Organization Name: Waterbury Vision Clinic LLC
Primary Specialty: Optometrist
Enumeration Date: Jan 31, 2015
Last Updated: Jan 31, 2015

Practice Location

Address: 4505 S 19TH ST
City: Tacoma
State: Washington
ZIP Code: 98405-1183
Phone: (253) 752-3961

Authorized Official

Name: TARA WATERBURY, OD
Title: MEMBER
Phone: (253) 617-8514

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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