| NPI | 1568654861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYME L OWENS Insurance Administration 208-552-7323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: ID 0818) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2016-02-05 |