Individual
DR. KELLY LYN BRUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
150 MCMAHAN BLVD, BUCKEYE OPTICAL, MARION, OH 43302-5654
(740) 389-1300
(740) 389-1335
Mailing address
150 MCMAHAN BLVD, BUCKEYE OPTICAL, MARION, OH 43302-5654
(740) 389-1300
(740) 389-1335
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5096
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2615781
—
OH
Enumeration date
06/08/2005
Last updated
07/16/2014
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