Organization
LARRY BREAZEL OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY D BREAZEAL O.D. (OWNER)
(509) 922-2400
Entity
Organization
Contact information
Practice address
509 N SULLIVAN RD STE G, SPOKANE VALLEY, WA 99037-8566
(509) 922-2400
(509) 922-1577
Mailing address
509 N SULLIVAN RD STE G, SPOKANE VALLEY, WA 99037-8566
(509) 922-2400
(509) 922-1577
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
602451136
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2029882
—
WA
Enumeration date
05/29/2007
Last updated
07/03/2012
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