NPI age
18 years
Enumerated 2008-02-26
Across 598 active optometrist providers in Idaho.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002182800 | |
| 01 (ID) | V7201 | BLUE CROSS |
| 01 (ID) | 000010015436 | REGENCE |
Multi-provider organization. 1 individual provider on file at this primary address.
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