| NPI | 1588840557 |
|---|---|
| Doing Business As | WILLIAM T BLACK |
| Entity Type | Organization |
| Authorized Contact | WILLIAM THOMAS BLACK Owner 208-459-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID ID0857) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2008-10-17 |