Individual
MR. BRYAN KEITH STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1722 BASHOR RD, GOSHEN, IN 46526-1302
(574) 533-4141
(574) 534-2278
Mailing address
1722 BASHOR RD, GOSHEN, IN 46526-1302
(574) 533-4141
(574) 534-2278
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1800-2579
IN
Other
Enumeration date
12/07/2005
Last updated
12/10/2013
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