Individual
BRUCE WELTON PRATTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1674 N LIMESTONE ST, SPRINGFIELD, OH 45503-2652
(937) 322-6411
(937) 399-2346
Mailing address
1674 N LIMESTONE ST, SPRINGFIELD, OH 45503-2652
(937) 322-6411
(937) 399-2346
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2836/T601
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000005257
ANTHEM BLUE CROSS BLUE SH
OH
05
—
0134367
—
OH
01
—
2220168
UNITED HEALTH CARE
OH
Enumeration date
07/18/2006
Last updated
11/28/2011
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