IndividualActive
David Bliese
NPI 1336200617 · Optometrist · Jackson, MO
Provider details
- NPI number
- 1336200617
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- TO2706 (MO)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
2317 Bainbridge Rd
Jackson, MO 63755-2343
Phone: (573) 243-6719
Fax: (573) 243-6719
Approximate (ZIP-level) locationGet directions
Mailing address
2317 Bainbridge Rd
Jackson, MO 63755
Registry dates
- Enumerated
- 2006-12-12
- Last updated
- 2016-10-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.