| NPI | 1538388624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN DAVID SPARHAWK Optometrist 208-461-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: ID ODP-100122) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |