| NPI | 1225227879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI L HALEY Optometric Physician 208-265-7965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID odp100004) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-12-04 |