Individual
AVI LEE BROCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
1829 NE ALBERTA ST, A, PORTLAND, OR 97211-5879
(503) 449-8455
Mailing address
1829 NE ALBERTA ST, SUITE A, PORTLAND, OR 97211-5879
(503) 449-8455
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00751
OR
Other
Enumeration date
10/03/2007
Last updated
10/03/2007
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