Individual
DR. DENNIS M BRTVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1015 S MERCER AVE, BLOOMINGTON, IL 61701-7107
(309) 213-9200
(309) 213-9300
Mailing address
1015 S MERCER AVE, BLOOMINGTON, IL 61701-7107
(309) 213-9200
(309) 213-9300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-007731
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007731
—
IL
Enumeration date
02/06/2006
Last updated
02/28/2022
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