| NPI | 1922115443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY HOWARD SANDERSON Optometry/Owner 208-547-2114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID 0-536) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-08-22 |