| NPI | 1902810757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLENE TRANMER Secretary Of Corporation 208-734-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |