SHANE BRAHM

LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS

Dr SHANE BRAHM is a male medical professional, specializing in Optometry. He graduated in 2015.

Contact

LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS

129 OLD ABE RD
LAC DU FLAMBEAU
WI
545389386

Tel: 7155883371

SHANE BRAHM Information

Npi 1831570761
Pac Id 3678885704
Professional Enrollment Id I20150702001115
Last Name BRAHM
First Name SHANE
Middle Name
Suffix
Gender M
Credential
Medical School Name OTHER
Graduation Year 2015
Primary Specialty OPTOMETRY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
Group Practice Pac Id 5496707242
Number Of Group Practice Members 14
Line 1 Street Address 129 OLD ABE RD
Line 2 Street Address
Marker Of Address Line 2 Suppression
City LAC DU FLAMBEAU
State WI
Zip Code 545389386
Phone Number 7155883371
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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