| NPI | 1780784769 |
|---|---|
| Doing Business As | SHELLEY EYECARE |
| Entity Type | Organization |
| Authorized Contact | KRISTAN C SPARKS Optometrist 208-357-5733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP 638) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ID ODP 100034) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2016-04-27 |