Broek, Verlyn Dean
Broek, Verlyn Dean is an sole proprietor health care provider with primary practice located at 215 4Th Ave N , Twin Falls ID 83301-6139. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Broek, Verlyn Dean can be contacted via phone (208) 734-5100.Contact Information
Primary practice address
215 4Th Ave N
Twin Falls ID 83301-6139
Phone: (208) 734-5100
Fax: (208) 734-5134
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-542 | Idaho |
Profile Details
| NPI number | 1760559223 |
|---|---|
| LBN Legal business name | Broek, Verlyn Dean |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 29th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760559223 | NPPES |
| Idaho | Other | 000010015324 | BLUE SHIELD |
| Idaho | Other | V5020 | BLUE SHIELD |
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