Individual
DR. BRETT ALLEN BALOCCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
18631 N 19TH AVE, SUITE 130, PHOENIX, AZ 85027-5299
(623) 516-4710
Mailing address
7071 N 138TH AVE, GLENDALE, AZ 85307-2006
(623) 516-4710
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1921
AZ
152W00000X
Optometrist
OPT.0002910
CO
Other
Enumeration date
07/19/2012
Last updated
02/10/2020
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