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:
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Health care specialties

SpecialtyCodeLicense #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 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619916137 NPPES
Iowa MEDICAID 0417964
Iowa Other 35259
Iowa Other 421417307H4

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