NPI age
19 years
Enumerated 2006-08-15
Across 598 active optometrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | T1560526754529 | VSP MEMBER NUMBER |
| 01 (ID) | 000010015459 | BLUE SHIELD |
| 05 (ID) | 001519300 | |
| 01 (ID) | V902-2 | BLUE CROSS |
Single-site organization. Only one practice location on file.
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