Organization
BRYAN D GRANGER OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN D GRANGER OD (PRESIDENT)
(337) 364-0425
Entity
Organization
Contact information
Practice address
1110 ANGERS ST, NEW IBERIA, LA 70563-2012
(337) 364-0425
(337) 364-0426
Mailing address
1110 ANGERS ST, NEW IBERIA, LA 70563-2012
(337) 364-0425
(337) 364-0426
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1366-535T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1621579
—
LA
Enumeration date
03/19/2008
Last updated
10/22/2008
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