NPI age
16 years
Enumerated 2010-05-20
Across 598 active optometrist providers in Idaho.
3 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | ODP-513 | IDAHO OPTOMETRY LICENSE |
| 01 (ID) | V109-4 | BLUE CROSS |
| 01 (ID) | 00010015323 | BLUE SHIELD |
| 05 (ID) | 002457600 | |
| 01 (ID) | 410007525 | RAIL ROAD |
Multi-provider organization. 3 individual providers on file at this primary address.
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