Aspen Ridge Eye Care, Pllc

NPI 1023223187 - Optometrist - 152W00000X

NPI Details
NPI 1023223187
Enumeration Date 05/11/2007
Last Updated 05/01/2013
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JERRY D JERRY
Position OWNER
Phone (208) 528-6900
Fax (208) 528-6904
Practice Location
3456 E 17TH ST
SUITE 150
AMMON ID, 83406-6757, US
Phone (208) 528-6900
Fax (208) 528-6904
Business Location
3456 E 17TH ST
SUITE 150
AMMON ID, 83406-6757, US
Phone (208) 528-6900
Fax (208) 528-6904
Toxanomy
Taxonomy Code 152W00000X
License State Idaho
License Number ODP-100104
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According to our database, Aspen Ridge Eye Care, Pllc NPI is 1023223187, taxonomy code is 152W00000X and license number is ODP-100104, license state is located at Idaho. Aspen Ridge Eye Care, Pllc physically located at 3456 E 17th St, Ammon ID, 83406-6757. NPI Number 1033115704 has the healthcare provider type.

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1023223187 NPI number is provided on an as is basis without warranty of any kind. 1023223187 is maintained by the National Plan & Provider Enumeration System. The contents of Aspen Ridge Eye Care, Pllc are for informational purposes only.