| NPI | 1700922044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELBERT OMAN Co Owner 208-678-3539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP-969) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ID ODP-501) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2015-03-19 |