Individual
SVETLANA BROADSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
2501 W HAPPY VALLEY RD, PHOENIX, AZ 85085-3701
(623) 780-5719
(623) 780-5721
Mailing address
2501 W HAPPY VALLEY RD, PHOENIX, AZ 85085-3701
(623) 780-5719
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
2471I
AZ
Other
Enumeration date
04/02/2025
Last updated
04/02/2025
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