| NPI | 1710088331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK GEORGE DOWANRD Owner / President 208-522-6933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID 000354660) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2010-08-19 |