Individual
DR. VERLYN DEAN BROEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
215 4TH AVE N, TWIN FALLS, ID 83301-6139
(208) 734-5100
(208) 734-5134
Mailing address
215 4TH AVE N, TWIN FALLS, ID 83301-6139
(208) 734-5100
(208) 734-5134
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-542
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015324
BLUE SHIELD
ID
01
—
V5020
BLUE CROSS
ID
Enumeration date
11/29/2006
Last updated
07/09/2007
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