| NPI | 1568664506 |
|---|---|
| Former Legal Business Name | SONNTAG EYE ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | JACOB ADAM MONG President 208-377-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ID O-0860) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ID ODP-100002) |
| 152W00000X Optometrist (Licence: ID ODP-100417) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2021-10-21 |