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Individual

BRUCE E BENEDICT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
617 S PINE ST, GRANTSBURG, WI 54840-7935
(715) 463-2459
Mailing address
23940 GREY FOX LN, GRANTSBURG, WI 54840-8551
(715) 463-2459

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1329-035
WI

Other

Enumeration date
09/05/2005
Last updated
07/08/2007
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