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Individual

LOWELL PARDEE BRANSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
0.D.

Contact information

Practice address
8332 N 7TH ST, PHOENIX, AZ 85020-3441
(602) 944-2656
(602) 870-4605
Mailing address
8332 N 7TH ST, PHOENIX, AZ 85020-3441
(602) 944-2656
(602) 870-4605

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0022
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
035594
AHCCCS
AZ
01
0450860001
DMERC
AZ
Enumeration date
07/13/2005
Last updated
07/08/2007
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