Individual
CARSON MATTHEW BRUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 S 2ND ST, COLDWATER, OH 45828-1747
(937) 417-4581
Mailing address
6050 ANNA M AVE, GREENVILLE, OH 45331-9609
(937) 417-4581
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7159
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2023
Last updated
07/17/2023
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