Individual
MRS. MADALYNN DIANNE BRUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
506 WABASH AVENUE, TERRE HAUTE, IN 47807-3525
(812) 232-0073
(812) 232-0074
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003979A
IN
Other
Enumeration date
06/30/2016
Last updated
05/31/2024
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