| NPI | 1972819365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAH S MILLS Owner 208-459-2641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2011-02-24 |