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Individual

BRIAN K NORMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
21 DOCTORS PARK, SUITE B, CAPE GIRARDEAU, MO 63703-4927
(573) 803-2211
Mailing address
21 DOCTORS PARK, SUITE B, CAPE GIRARDEAU, MO 63703-4927
(573) 803-2211

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T03491
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
T03491
MISSOURI OPTOMETRY LICENSE
MO
Enumeration date
12/19/2006
Last updated
06/26/2012
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