| NPI | 1851663512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODGER DEAN ROBERTSON Optometric Physician 208-882-2932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP-552) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-01-27 |