Individual
BRIANA BOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
734
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1464575
—
ND
01
—
N721435
MEDICARE PTAN
—
Enumeration date
04/21/2015
Last updated
12/28/2017
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