Individual
BRUCE L BRODMERKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1115 WASHINGTON ST, CHILLICOTHE, MO 64601-1306
(660) 646-3937
(660) 646-4092
Mailing address
1115 WASHINGTON ST, CHILLICOTHE, MO 64601-1306
(660) 646-3937
(660) 646-4092
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02410
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311757003
—
MO
Enumeration date
06/15/2006
Last updated
11/03/2010
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