| NPI | 1407148109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY JAMES LATTIMORE O PT Ometric Physician 208-522-6271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID 505) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2011-05-12 |