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1821082470
LANCE F OUGH
BOISE, ID
NPI
1821082470
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152WC0802X Optometrist, Corneal and Contact Management
(Licence: ID ODP 100038)
Enumeration Date
2005-09-08
Last Update Date
2007-07-08
Business Address
-- LANCE F OUGH O.D.
350 N MILWAUKEE ST #2153
BOISE, ID 83704-9123
Phone number: 208-322-1642
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Mailing Address
-- LANCE F OUGH O.D.
20 QUAIL LN
BOISE, ID 83716-3114
Phone number: 208-343-0046
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