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Individual

RONALD A BRAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1702 N. BALTIMORE ST., KIRKSVILLE, MO 63501-2485
(660) 665-6262
(660) 665-5908
Mailing address
1702 N. BALTIMORE ST., KIRKSVILLE, MO 63501-2485
(660) 665-6262
(660) 665-5908

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
002575
IA
152W00000X
Optometrist
046007820
IL
152W00000X
Optometrist
Primary
T02642
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1164471462
IA
05
1164471462
IL
05
317965804
MO
Enumeration date
05/06/2006
Last updated
02/16/2018
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