Provider Demographics
NPI:1801109103
Name:BRETZ, REBEKAH D (OD)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:D
Last Name:BRETZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:REBEKAH
Other - Middle Name:D
Other - Last Name:KARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:7437 VILLAGE SQUARE DR
Mailing Address - Street 2:#115
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-4600
Mailing Address - Country:US
Mailing Address - Phone:303-688-5066
Mailing Address - Fax:303-688-6986
Practice Address - Street 1:608 GARRISON ST
Practice Address - Street 2:SUITE E
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-5881
Practice Address - Country:US
Practice Address - Phone:303-232-0200
Practice Address - Fax:303-232-4044
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2788152W00000X
CA13982152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist