Individual
DR. RONALD BRACKENBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1700 E 38TH ST, MARION, IN 46953-4568
(765) 674-3321
Mailing address
723 W EUCLID AVE, MARION, IN 46952-3456
(765) 664-3224
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002344A
IN
152W00000X
Optometrist
—
IL
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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