Individual
JILLYNN F BRUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
201 S 2ND ST, COLDWATER, OH 45828-1747
(419) 678-3016
(419) 678-8849
Mailing address
PO BOX 95, COLDWATER, OH 45828-0095
(419) 678-3016
(419) 678-8849
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4175
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0799275
—
OH
Enumeration date
08/24/2006
Last updated
04/09/2008
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