| NPI | 1174632244 |
|---|---|
| Doing Business As | KETCHUM EYECENTER |
| Entity Type | Organization |
| Authorized Contact | ROBERT B GRILL Owner Optometrist 208-734-9800 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-01-08 |