Brady L Wilborn, O.D.
Optometrist in California, MO. Individual provider (NPI-1).
NPI number1124025879
StatusActive
Last updated in NPPESJul 19, 2007
Details
- NPI
- 1124025879
- Entity type
- Individual (NPI-1)
- Name
- Brady L Wilborn
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 7, 2005
- Last updated
- Jul 19, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 168620 | MO | Yes |
| 152W00000X | Optometrist | 1608 | KS |
Practice location
202 E North StCalifornia, MO 65018-1583
Phone 573-796-2222 · Fax 573-796-4184
Mailing address
202 E North StCalifornia, MO 65018-1583
Phone 573-796-2222 · Fax 573-796-4184
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Other Optometrist providers in California, MO
- Jacqueline ByrdNPI 1023549011
- Donald J. VanderfeltzNPI 1700920915
- Jill Denise Smith Radkowiec, ODNPI 1114239092
- Cole Edward Vanderfeltz, ODNPI 1740061621
- Donald J Vanderfeltz, O. D.NPI 1225040249
- Ryan Curtis Wilkerson, ODNPI 1447601679
All 7 Optometrist providers in California · All 65 providers in California
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