Individual
MR. BRUCE RICHARD LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
202 S MAIN ST, ELKADER, IA 52043-9078
(563) 245-2304
(563) 245-2392
Mailing address
202 S MAIN ST, PO BOX 100, ELKADER, IA 52043-0100
(563) 245-2304
(563) 245-2392
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1715
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0069633
—
IA
Enumeration date
09/29/2005
Last updated
08/13/2008
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