Guthrie Vision Source Pc, Inc.

NPI #1982625703 in Guthrie, Oklahoma

Provider Information

NPI Number: 1982625703
Entity Type: Organization
Organization Name: Guthrie Vision Source Pc, Inc.
Primary Specialty: Optometrist
Enumeration Date: Jul 21, 2006
Last Updated: Feb 4, 2008

Practice Location

Address: 110 E HARRISON AVE
City: Guthrie
State: Oklahoma
ZIP Code: 73044-4839
Phone: (405) 282-4396

Authorized Official

Name: MICHAEL E. BENNETT, O.D.
Title: PRESIDENT
Phone: (405) 282-4396

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X
Optometrist	152W00000X	Primary

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