Individual
MR. BRANDON CLARK HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
999 N CURTIS SUITE 205, BOISE, ID 83706-1336
(208) 373-1200
(208) 373-1216
Mailing address
999 N CURTIS SUITE 205, BOISE, ID 83706-1336
(208) 373-1200
(208) 373-1216
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
7719282-9934
UT
152W00000X
Optometrist
Primary
ODP-100580
ID
Other
Enumeration date
08/02/2010
Last updated
06/22/2023
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