Johnson, Bradley Aaron
Johnson, Bradley Aaron is an individual health care provider with primary practice located at 909 E San Marnan Drive , Waterloo IA 50702-5611. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Johnson, Bradley Aaron can be contacted via phone (319) 234-2616.Contact Information
Primary practice address
909 E San Marnan Drive
Waterloo IA 50702-5611
Phone: (319) 234-2616
Fax: (319) 234-1939
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | 02255 | Iowa |
Profile Details
NPI number | 1619916137 |
---|---|
LBN Legal business name | Johnson, Bradley Aaron |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 6th, 2006 |
Last updated | Feb 7th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1619916137 | NPPES |
Iowa | MEDICAID | 0417964 | |
Iowa | Other | 35259 | |
Iowa | Other | 421417307H4 |
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