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Individual

MRS. TIFFANY JOY BRINK

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
2325 W 57TH ST, SIOUX FALLS, SD 57108-5046
(605) 275-6100
(605) 275-6105
Mailing address
2325 W 57TH ST, SIOUX FALLS, SD 57108-5046
(605) 275-6100
(605) 275-6105

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T0568
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007147
BLUE CROSS BLUE SHIELD
SD
01
23017
SIOUX VALLEY HEALTH PLAN
SD
05
9203200
SD
Enumeration date
09/02/2005
Last updated
01/06/2023
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