| NPI | 1972525947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE ROBLING Administrator 208-498-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2008-07-21 |