Individual
DR. NICHOLAS JAMES BRATTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
120-T
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104085500
—
WY
01
—
301361
BLUE CROSS KID CARE
WY
01
—
4591070
PIN
—
Enumeration date
02/23/2007
Last updated
05/01/2013
Update your record
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