Doctor Name: | LEANNA BRONNI |
NPI Number: | 1043405871 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ABOC |
License Number: | |
Business Practice Address: | 24452 Charles Dr Brownstown, MI - 481832589 |
Business Phone Number: | 7347898255 |
Business Fax Number: | 7347898257 |
Mailing Address: | 24452 Charles Dr, BROWNSTOWN |
State: | MI |
Postal Code: | 481832589 |
Phone Number: | 7347898255 |
Fax Number: | 7347898257 |
NPI Enumeration Date: | 09/14/2007 |
NPI Last Update Date: | 09/14/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |