NPI age
19 years
Enumerated 2007-05-15
Across 598 active optometrist providers in Idaho.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | V3918 | BLUE CROSS |
| 01 (ID) | 000010026621 | BLUE SHIELD |
| 01 (ID) | 167539 | COLE |
| 05 (ID) | 805561900 |
Multi-provider organization. 1 individual provider on file at this primary address.
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