Individual
MRS. CHERYL BRONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
714 S GRAND AVE, SPENCER, IA 51301-5730
(712) 262-3982
Mailing address
1626 7TH AVE SE, SIOUX CENTER, IA 51250-1197
(720) 363-3192
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02040
IA
152W00000X
Optometrist
OPT1692
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
638733
BCBS PROVIDER NUMBER
CO
Enumeration date
07/08/2006
Last updated
01/25/2016
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