Provider Demographics
NPI: | 1477725711 |
---|---|
Name: | BRESSMAN ANIMAL CLINIC |
Entity type: | Organization |
Organization Name: | BRESSMAN ANIMAL CLINIC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/VETERINARIAN |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RICHARD |
Authorized Official - Middle Name: | B |
Authorized Official - Last Name: | BRESSMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DVM |
Authorized Official - Phone: | 772-283-0101 |
Mailing Address - Street 1: | 6755 S KANNER HWY |
Mailing Address - Street 2: | |
Mailing Address - City: | STUART |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 34997-7420 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 772-283-0101 |
Mailing Address - Fax: | 772-283-1660 |
Practice Address - Street 1: | 6755 S KANNER HWY |
Practice Address - Street 2: | |
Practice Address - City: | STUART |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34997-7420 |
Practice Address - Country: | US |
Practice Address - Phone: | 772-283-0101 |
Practice Address - Fax: | 772-283-1660 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-03-27 |
Last Update Date: | 2008-03-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | 174M00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 174M00000X | Other Service Providers | Veterinarian | Group - Single Specialty |