| NPI | 1407915325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LEACH Owner President 208-882-4662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ID M8044) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ID ODP100095) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2011-03-03 |