NPI age
19 years
Enumerated 2006-10-18
Across 598 active optometrist providers in Idaho.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1369050 | MEDICARE PTAN |
| 05 (WA) | 2031375 | |
| 01 (ID) | 000010015178 | REGENCE PROVIDER NO |
| 01 | DF0013 | RAILROAD MEDICARE-PTAN |
| 05 (ID) | 807324500 | |
| 01 (ID) | V7166 | BC OF ID GRP PROVIDER NO |
Multi-provider organization. 1 individual provider on file at this primary address.
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