NPI age
19 years
Enumerated 2006-11-15
Across 598 active optometrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (WA) | 2029890 | |
| 05 (ID) | 805604301 |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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