Individual
TYREL J BRUNEEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
8445 N GOVERNMENT WAY, HAYDEN, ID 83835-9280
(208) 772-3208
(208) 762-2574
Mailing address
8445 N GOVERNMENT WAY, HAYDEN, ID 83835-9280
(208) 772-3208
(208) 762-2574
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP100469
ID
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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