| NPI | 1164455259 |
|---|---|
| Doing Business As | CANYON CREST EYE PHYS |
| Entity Type | Organization |
| Authorized Contact | JASON T HALVERSON Owner 208-733-5300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2023-04-24 |