JAY LESLIE BORGHOLTHAUS

POCATELLO, ID
NPI1952353716
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy152W00000X Optometrist
(Licence: ID  ODP-865)
Enumeration Date2006-05-17
Last Update Date2016-06-22
Business Address
Dr. JAY LESLIE BORGHOLTHAUS OD
301 S 4TH AVE # C-2
POCATELLO, ID 83201-6462
Phone number: 208-637-0841
Mailing Address
Dr. JAY LESLIE BORGHOLTHAUS OD
301 S 4TH AVE # C-2
POCATELLO, ID 83201-6462
Phone number: 208-637-0841
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