Individual
BRADLEY C MARCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 N MAIN ST, GORDON, NE 69343-1524
(308) 282-0820
Mailing address
112 N MAIN, GORDON, NE 69343
(308) 282-0820
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
694
SD
Other
Enumeration date
07/29/2013
Last updated
07/29/2013
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