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General NPI Number Information
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NPI Number | 1275527475
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Entity Type | Individual
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Provider Name | TIFFANY JOY BRINK OD
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Gender | Female
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 01/06/2023
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Provider Practice Location Address
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Address Line | 2325 W 57TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57108-5046
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Country | US
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Telephone | 605-275-6100
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Fax | 605-275-6105
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Provider Business Mailing Address
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Address Line | 2325 W 57TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57108-5046
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Country | US
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Telephone | 605-275-6100
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Fax | 605-275-6105
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T0568
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License Number State | SD
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