Individual
BRANDON RIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
101 W DECATUR ST, WEST POINT, NE 68788-1407
(402) 372-3266
(402) 372-5736
Mailing address
101 W DECATUR ST, WEST POINT, NE 68788-1407
(402) 372-3266
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
002602
IA
152W00000X
Optometrist
Primary
1396
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
465019378
BLUE CROSS BLUE SHIELD OF NE
NE
05
—
465019378
—
NE
Enumeration date
06/27/2013
Last updated
12/03/2014
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