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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LEE BROCK WREN, OD

Active

LEE BROCK WREN, OD is a Optometrist healthcare provider located in BLACKFOOT, Idaho. NPI 1215120696 is currently active in the NPPES registry. Verify at CMS.

Optometrist · BLACKFOOT, ID

Registration Details

NPI Number
1215120696
Provider Type
Individual
Gender
Male
NPI Issued
Aug 20, 2007 (18.9595265702 yrs)
Last Updated
Sep 10, 2019
Licenses
66612099934 (UT)
ODP-100148 (ID)

Practice Information

Address
715 W JUDICIAL ST
BLACKFOOT, ID, 832212036
Browse ID providers · Browse ZIP 83221
Phone
2087852210
Fax
2087852216
Primary Specialty
Optometrist
152W00000X
Additional Specialty
Optometrist

Other Optometrist Providers in BLACKFOOT, ID

Name Credential NPI
DENNIS N MARSHALL O.D., P.A. 1477548220
DR. FREDERICK GEORGE DOWNARD O.D. 1801997424
MR. CODY E JONES O.D. 1255426912
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.