Individual
DR. SHANE BRAHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
129 OLD ABE RD, LAC DU FLAMBEAU, WI 54538-9386
(715) 588-3371
(715) 588-2039
Mailing address
129 OLD ABE RD, LAC DU FLAMBEAU, WI 54538-9386
(715) 588-3371
(715) 588-2039
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3376-35
WI
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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