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General NPI Number Information
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NPI Number | 1841206372
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Entity Type | Individual
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Provider Name | BETHANY HILTERMAN BRADY O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 1600 PENINSULA DR STE 15
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City | ERIE
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State | PA
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Zip | 16505-4261
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Country | US
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Telephone | 814-920-5010
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Fax | 814-920-5070
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Provider Business Mailing Address
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Address Line | 7376 GARFIELD AVE
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City | HARBORCREEK
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State | PA
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Zip | 16421-1405
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Country | US
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Telephone | 814-873-0792
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG001062
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License Number State | PA
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