Individual
DR. ROBERT BENTLY WOODHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2150 E KIMBERLY RD, DAVENPORT, IA 52807-2225
(563) 359-0791
Mailing address
2150 E KIMBERLY RD, DAVENPORT, IA 52807-2225
(563) 359-0791
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1699
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002543
—
IA
Enumeration date
03/29/2007
Last updated
07/08/2007
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