STEPHEN BROCKBANK O.D. L.L.C.
Optometry at 12 St, Lewiston, ID

License number
Idaho ODP100049
Category
Optometry
Type
Optometrist
Owner
Name: STEPHEN R BROCKBANK O.D.
Title: OPTOMETRIST/OFFICER
Phone: (208) 883-1800
Address
Address
3510 12Th St SUITE 400, Lewiston, ID 83501
National Provider ID: 1750511184
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about STEPHEN BROCKBANK O.D. L.L.C. at bizstanding.com

STEPHEN BROCKBANK, O.D., LLC

Lewiston, ID

Status:
Inactive
Industry:
Optometrist's Office
Doing business as:
Stephen Brockbank<br>Alpine Vision Center<br>Stephen Brockbank OD
Registration:
Sep 8, 2005
Inactive since:
Dec 9, 2011
Addresses:
3510 12 St STE 400, Lewiston, ID 83501 (Physical)
739 Bryden Ave, Lewiston, ID 83501
State ID:
W42577
Business type:
LIMITED LIABILITY COMPANY
Entity State:
UT
Owner, President, Principal, Od, Officer:
Stephen Brockbank Owner, President, Principal, Od, Officer, inactive

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