| NPI | 1790027332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA G DAVIS O PT Ometrist/President 208-757-1227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: ID ODP 100167) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2013-04-02 |