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Individual

DR. BLAINE R BRUNSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2628 BEAVER AVE, DES MOINES, IA 50310-3908
(515) 274-4141
Mailing address
2628 BEAVER AVE, DES MOINES, IA 50310-3908
(515) 274-4141

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002417
IA
152W00000X
Optometrist
2057
CO

Other

Enumeration date
07/05/2006
Last updated
02/09/2009
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