Provider Demographics
NPI:1174888770
Name:MILLBROOK EYE CARE
Entity type:Organization
Organization Name:MILLBROOK EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:334-285-4828
Mailing Address - Street 1:758 MONUMENT DR
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:AL
Mailing Address - Zip Code:36054-1849
Mailing Address - Country:US
Mailing Address - Phone:334-285-4828
Mailing Address - Fax:334-285-4881
Practice Address - Street 1:3331 HIGHWAY 14
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:AL
Practice Address - Zip Code:36054-1838
Practice Address - Country:US
Practice Address - Phone:334-285-4828
Practice Address - Fax:334-285-4881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-B81-TA-793152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty