Individual
DR. BRIAN A DITTENBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
690 W CHERRY ST, SUNBURY, OH 43074-8556
(740) 965-4671
Mailing address
690 W CHERRY ST, SUNBURY, OH 43074-8556
(740) 965-4671
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3226
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0400793
—
OH
Enumeration date
01/03/2007
Last updated
07/08/2007
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