| NPI | 1619185485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN M. POLATIS President 208-869-1965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: ID ODP-900) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2023-03-07 |