Provider Demographics
NPI:1194456533
Name:YAROCH, BRENDON PATRICK (OD)
Entity type:Individual
Prefix:DR
First Name:BRENDON
Middle Name:PATRICK
Last Name:YAROCH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 SAXONWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:WI
Mailing Address - Zip Code:54720-2753
Mailing Address - Country:US
Mailing Address - Phone:517-375-5297
Mailing Address - Fax:
Practice Address - Street 1:509 E SOUTH AVE
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-3402
Practice Address - Country:US
Practice Address - Phone:715-726-9077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program