| NPI | 1992114615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED REESE IVIE Owner/Optometrist 208-529-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: ID ODP100241) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2023-06-21 |