| NPI | 1316013691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY J KENT Owner President 208-342-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-04-18 |