| NPI | 1649601006 |
|---|---|
| Doing Business As | BRYDEN FAMILY VISION |
| Entity Type | Organization |
| Authorized Contact | CARMINE PETRACCA Owner 208-743-1761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: ID ODP-634) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2013-12-10 |