Individual
BRYAN GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
483 W SEED FARM RD, SACATON, AZ 85147-5000
(602) 271-7960
Mailing address
PO BOX 38, SACATON, AZ 85147-1255
(602) 528-1200
(602) 528-1255
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002505
AZ
Other
Enumeration date
07/01/2021
Last updated
10/27/2021
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