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Individual

MR. BARRY JAMES JOSE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1601 AVE D, COUNCIL BLUFFS, IA 51501
(712) 323-5213
(712) 323-0722
Mailing address
1601 AVE D, COUNCIL BLUFFS, IA 51501
(712) 323-5213
(712) 323-0722

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1644
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1140202
IA
Enumeration date
04/11/2006
Last updated
07/08/2007
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