| NPI | 1477608610 |
|---|---|
| Doing Business As | BRIDGEPORT VISION SOURCE |
| Entity Type | Organization |
| Authorized Contact | TAMARA FRANKLIN Corporation Secretary 308-262-1252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2008-04-11 |