| NPI | 1134295116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL R. BOESPFLUG President 208-322-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP-683) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: ID ODP-683) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2010-08-09 |