SHANE L WYNN

IDAHO FALLS, ID
NPI1427125491
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy152W00000X Optometrist
(Licence: ID  00p10064)
Enumeration Date2006-11-28
Last Update Date2007-07-08
Business Address
Dr. SHANE L WYNN OD
2025 E 17TH ST
IDAHO FALLS, ID 83404
Phone number: 208-524-2025
Mailing Address
Dr. SHANE L WYNN OD
2025 E 17TH ST
IDAHO FALLS, ID 83404
Phone number: 208-524-2025