NPI age
12 years
Enumerated 2014-03-26
Across 4 active ophthalmology providers in Idaho.
1 secondary location on file with NPPES.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1699742395 |
Multi-provider organization. 1 individual provider on file at this primary address. Plus 1 secondary practice location.
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