Organization
STEPHEN BROCKBANK O.D. L.L.C.
Active
Other names
Alpine Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN R BROCKBANK O.D. (OPTOMETRIST/OFFICER)
(208) 883-1800
Entity
Organization
Contact information
Practice address
3510 12TH ST, SUITE 400, LEWISTON, ID 83501-5575
(208) 743-5830
(208) 743-5831
Mailing address
3510 12TH ST, SUITE 400, LEWISTON, ID 83501-5575
(208) 743-5830
(208) 743-5831
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP100049
ID
Other
Enumeration date
07/20/2009
Last updated
09/11/2009
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