Provider Demographics
NPI:1861246340
Name:BRIGHT FUTURE VISION CARE
Entity type:Organization
Organization Name:BRIGHT FUTURE VISION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:505-514-6028
Mailing Address - Street 1:4644 N 22ND ST UNIT 2112
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4672
Mailing Address - Country:US
Mailing Address - Phone:505-514-6028
Mailing Address - Fax:
Practice Address - Street 1:4644 N 22ND ST UNIT 2112
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4672
Practice Address - Country:US
Practice Address - Phone:505-514-6028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty