Individual
DR. MICHAEL BRAYDEN LUNDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD, FAAO, FSLS
Contact information
Practice address
2580 N LITCHFIELD RD, GOODYEAR, AZ 85395-2049
(623) 932-2020
Mailing address
2580 N LITCHFIELD RD, GOODYEAR, AZ 85395-2049
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
10186731-9934
UT
152WC0802X
Corneal and Contact Management Optometrist
Primary
2115
AZ
152WC0802X
Corneal and Contact Management Optometrist
3222
TN
Other
Enumeration date
07/06/2015
Last updated
03/01/2018
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