Individual
KRISTANZA MARIE BRONNENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
620 19TH ST, CODY, WY 82414-3305
(307) 587-4206
(307) 587-5539
Mailing address
PO BOX 2810, CODY, WY 82414-2810
(307) 587-4206
(307) 587-5539
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
429T
WY
Other
Enumeration date
10/07/2019
Last updated
12/18/2020
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