NPI age
14 years
Enumerated 2011-06-30
Across 598 active optometrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 | V71668 | BLUE CROSS |
| 01 | 000010153551 | REGENCE |
| 05 (WA) | 1831486687 |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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