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Individual

DR. BRIAN A ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
384 1ST ST, MANISTEE, MI 49660-1751
(231) 723-9911
Mailing address
384 1ST ST, MANISTEE, MI 49660-1751
(231) 723-9911

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003074
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0E17604002
BCBS
MI
05
1785092
MI
01
410045293
RR MEDICARE
MI
Enumeration date
11/14/2006
Last updated
01/10/2009
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