| NPI | 1255456323 |
|---|---|
| Doing Business As | RETINA CONSULTANTS OF IDAHO |
| Entity Type | Organization |
| Authorized Contact | SCOTT C SIMPSON Manager 208-855-5950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |