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Individual

DR. STEPHEN BROCKBANK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
222 S MAIN ST, SUITE 110, SALT LAKE CITY, UT 84101-2174
(801) 456-2020
(801) 456-2021
Mailing address
2847 N 1050 E, LEHI, UT 84043-4033
(801) 456-2020
(801) 456-2021

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5601485-9934
UT

Other

Enumeration date
08/25/2006
Last updated
06/04/2013
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