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STEPHEN BROCKBANK, O.D., LLC

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Company Details

Name: STEPHEN BROCKBANK, O.D., LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Inactive-Cancelled (Administrative)
Date of registration: 08 Sep 2005 (20 years ago)
Financial Date End: 30 Sep 2011
Date dissolved: 09 Dec 2011
Entity Number: 139793
Place of Formation: UTAH
File Number: 139793
ZIP code: 83501
County: Nez Perce County
Principal Address: 3510 12TH ST STE 400 LEWISTON, ID 83501

National Provider Identifier

NPI Number:
1750511184

Authorized Person:

Name:
STEPHEN R BROCKBANK
Role:
OPTOMETRIST/OFFICER
Phone:

Taxonomy:

Selected Taxonomy:
152W00000X - Optometrist
Is Primary:
Yes

Contacts:

Fax:
2087435831

Filing

Filing Name Filing Number Filing date
Annual Report 0001460015 2010-10-11
Annual Report 0001460014 2009-08-18
Annual Report 0001460017 2008-07-21
Annual Report 0001460016 2007-09-10
Annual Report 0001460013 2006-07-31

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Date of last update: 27 May 2025

Sources: Idaho Secretary of State