Trey Dean Carlisle, O.D. Valid NPI
Individual provider · Optometrist · Beaver, OK
- NPI
- 1629357116
- Type
- Individual (Type 1)
- Primary specialty
- Optometrist
- Specialty group
- Eye and Vision Services Providers
- Taxonomy code
- 152W00000X
- License number
- 2685 (OK)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2011-08-15
- Last updated
- 2012-06-19
Practice location
712 Ave. A
Beaver, OK 73932
(580) 625-2020