Individual
DR. BROOKE LOUISE VETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1990 MCCULLOCH BLVD N STE 101, LAKE HAVASU FAMILY EYECARE, LAKE HAVASU CITY, AZ 86403-5749
(928) 855-5026
Mailing address
1990 MCCULLOCH BLVD N STE 101, LAKE HAVASU CITY, AZ 86403-5749
(928) 855-5026
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1566
AZ
152W00000X
Optometrist
5394153-9934
UT
Other
Enumeration date
11/24/2006
Last updated
10/02/2008
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