Individual
DR. BRENTON DOUGLAS ORMISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3275 W 3RD ST, BLOOMINGTON, IN 47404-4835
(812) 287-8742
(812) 287-8752
Mailing address
2808 E WINSTON ST, BLOOMINGTON, IN 47401-4450
(812) 361-5864
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1595-628T
LA
152W00000X
Optometrist
Primary
18003561A
IN
152W00000X
Optometrist
1833DT
KY
152W00000X
Optometrist
5992
OH
152W00000X
Optometrist
8142T
TX
152W00000X
Optometrist
OPT-2544
CO
Other
Enumeration date
11/13/2006
Last updated
06/10/2014
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