NPI age
20 years
Enumerated 2006-04-10
Across 598 active optometrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | DC5197 | RAILROAD MEDICARE |
| 01 (ID) | V6531 | BLUE CROSS |
| 01 (ID) | 000010147608 | BLUE SHIELD |
| 05 (ID) | 806929900 |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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