Individual
GREG R BROCKBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
123 W FRANCIS, SPOKANE, WA 99205
(509) 483-9363
(509) 483-0355
Mailing address
123 W FRANCIS, SPOKANE, WA 99205
(509) 483-9363
(509) 483-0355
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO0000780
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200644
LABOR AND INDUSTRY
WA
05
—
8430522
—
WA
01
—
P00326450
RAILRAOD MEDICARE
WA
Enumeration date
10/26/2006
Last updated
04/30/2008
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