Individual
DR. JOHNNY BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
215 PERRY HILL RD, MONTGOMERY, AL 36109-3725
(334) 272-4670
(334) 273-6254
Mailing address
2913 MOORCROFT DR, MONTGOMERY, AL 36116-3311
(334) 272-4670
(334) 273-6254
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
AL-S496
AL
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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