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BRANDON RIDDER O.D.

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1851731459

Individual Registrant:
 BRANDON  RIDDER O.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
101 W DECATUR ST  WEST POINT, NE 68788-1407 US
Tel: 402-372-3266  Fax: 402-372-5736

Contact information for business:
101 W DECATUR ST  WEST POINT, NE 68788-1407 US
Tel: 402-372-3266  Fax: --

Registration Information:
NPI: 1851731459
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N152W00000XEye and Vision Services Providers
Optometrist
IA002602
Y152W00000XEye and Vision Services Providers
Optometrist
NE1396

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BLUE CROSS BLUE SHIELD OF NE465019378NE01
465019378NE05




HEALTH CARE JOBS NE - Page 1



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