Organization
BEAVERDALE EYE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAINE R BRUNSEN O.D. (OWNER)
(515) 274-4141
Entity
Organization
Contact information
Practice address
2628 BEAVER AVE, DES MOINES, IA 50310-3908
(515) 274-4141
(515) 274-4144
Mailing address
2628 BEAVER AVE, DES MOINES, IA 50310-3908
(515) 274-4141
(515) 274-4144
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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