NPI 1306354147

Logan Jose Granera

Practitioner Optometrist Burlington, IA

Practice location

Address: 2743 Mount Pleasant St, Burlington, IA 52601
Phone: (319) 754-2020
Mailing address: 2743 Mount Pleasant St, Burlington, IA 52601-2137

Registered specialties (2)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 092219 (IA)

Other Optometrist providers in Iowa →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Iowa →

Registry record

NPI: 1306354147
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Jan 2018
Record last updated: 14 Jun 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.