| NPI | 1447444716 |
|---|---|
| Doing Business As | TETON VALLEY VISION CLINIC |
| Entity Type | Organization |
| Authorized Contact | THOMAS LYLE SIMMONS Optometrist 208-787-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP-100009) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2008-06-18 |