IndividualActive
Bobby Pettit
NPI 1679761159 · Optician · Glendale, AZ
Provider details
- NPI number
- 1679761159
- Entity type
- Individual
- Primary specialty
- OpticianEye and Vision Services Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 644 (AZ)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
5830 W Thunderbird Rd Ste B5
Glendale, AZ 85306-4655
Phone: (602) 841-7886
Approximate (ZIP-level) locationGet directions
Mailing address
5830 W Thunderbird Rd Ste B5
Glendale, AZ 85306-4655
Registry dates
- Enumerated
- 2007-10-09
- Last updated
- 2007-10-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.