Individual
BRYANT M SENICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
40 CAPRI BLVD, SUITE 102, LAKE HAVASU CITY, AZ 86403-5661
(928) 855-9477
(928) 855-1799
Mailing address
40 CAPRI BLVD, SUITE 102, LAKE HAVASU CITY, AZ 86403-5661
(928) 855-9477
(928) 855-1799
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
898
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
316499
—
AZ
01
—
AZ0903020
BCBS
AZ
Enumeration date
02/02/2006
Last updated
02/29/2008
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