Samuel Heber Kimball OD

NPI 1144458860 - Optometrist - 152W00000X

NPI Details
NPI 1144458860
Gender Male
Enumeration Date 07/01/2009
Last Updated 07/01/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
1502 N PINE ST
LA GRANDE OR, 97850-3543, US
Phone (541) 963-3788
Fax (541) 963-3091
Business Location
1502 N PINE ST
LA GRANDE OR, 97850-3543, US
Phone (541) 963-3788
Fax (541) 963-3091
Toxanomy
Taxonomy Code 152W00000X
License State Oregon
License Number 3311AT
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According to our database, Dr. Samuel Heber Kimball OD NPI is 1144458860, taxonomy code is 152W00000X and license number is 3311AT, license state is located at Oregon. Samuel Heber Kimball OD physically located at 1502 N Pine St, La Grande OR, 97850-3543. NPI Number Samuel Heber Kimball OD has the Individual type.

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1144458860 NPI number is provided on an as is basis without warranty of any kind. 1144458860 is maintained by the National Plan & Provider Enumeration System. The contents of Samuel Heber Kimball OD are for informational purposes only.