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Individual

DR. THOMAS W GRANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1103 GALVIN RD S, SUITE H, BELLEVUE, NE 68005-3002
(402) 292-6514
(402) 292-7122
Mailing address
1103 GALVIN RD S, BELLEVUE, NE 68005-3002
(402) 292-6514

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
01937
IA
152W00000X
Optometrist
2081
MN
152W00000X
Optometrist
Primary
915
NE

Other

Enumeration date
05/25/2006
Last updated
02/10/2010
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