| NPI | 1366794299 |
|---|---|
| Former Legal Business Name | SNAKE RIVER EYECARE LLC |
| Entity Type | Organization |
| Authorized Contact | DENNIS SCOTT RADFORD Owner 208-881-5145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2013-08-02 |