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Stephen Brockbank O.d. L.l.c.

NPI #1750511184 in Lewiston, Idaho

Provider Information

NPI Number
1750511184
Entity Type
Organization
Organization Name
Stephen Brockbank O.d. L.l.c.
Primary Specialty
Optometrist
Enumeration Date
Jul 20, 2009
Last Updated
Sep 11, 2009

Practice Location

Address
3510 12TH ST
Address 2
SUITE 400
City
Lewiston
State
Idaho
ZIP Code
83501-5575
Phone
(208) 743-5830

Authorized Official

Name
STEPHEN R BROCKBANK, O.D.
Title
OPTOMETRIST/OFFICER
Phone
(208) 883-1800

Specialties & Taxonomy Codes

Specialty
Optometrist

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