Doctor Name: | DR. BRYCE BYRAM THUESON |
NPI Number: | 1144260969 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | O.D. |
License Number: | ODP-100014 |
Business Practice Address: | 76 Professional Plz Rexburg, ID - 834402047 |
Business Phone Number: | 2083564585 |
Business Fax Number: | 2083564587 |
Mailing Address: | 76 Professional Plz, REXBURG |
State: | ID |
Postal Code: | 834402047 |
Phone Number: | 2083564585 |
Fax Number: | 2083564587 |
NPI Enumeration Date: | 06/08/2006 |
NPI Last Update Date: | 07/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 152WC0802X |
License Number: | ODP-100014 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ID |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Optometrist |
Taxonomy Specialization: | Corneal and Contact Management |
Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |