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1477547628
BRADLEY S BASHAM
FORT WAYNE, IN
NPI
1477547628
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: IN 18002201)
Enumeration Date
2005-09-02
Last Update Date
2015-06-10
Business Address
Dr. BRADLEY S BASHAM O.D.
1515 E PAULDING RD
FORT WAYNE, IN 46816-1252
Phone number: 260-744-2273
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Mailing Address
Dr. BRADLEY S BASHAM O.D.
1515 E PAULDING RD
FORT WAYNE, IN 46816-1252
Phone number: 260-744-2273
Copy
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