Individual
BRADLEY JAMES CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
9737 GILES RD, LAVISTA, NE 68128-2930
(402) 963-0831
Mailing address
10040 SHANNON RD, LA VISTA, NE 68128-3253
(402) 339-4116
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1277
NE
Other
Enumeration date
06/29/2007
Last updated
07/19/2017
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