NPI age
20 years
Enumerated 2005-05-31
Across 598 active optometrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010138989 | REGENCE BLUE SHIELD |
| 05 (ID) | 806370300 | |
| 01 (ID) | V050-0 | BLUE CROSS |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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