Baird Optical Pc

NPI 1013206275 - Optometrist - 152W00000X

NPI Details
NPI 1013206275
Enumeration Date 03/28/2011
Last Updated 06/27/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name MICHAEL MICHAEL
Position CEO
Phone (208) 637-0841
Fax
Practice Location
301 S 4TH AVE # C-2
POCATELLO ID, 83201-6462, US
Phone (208) 637-0841
Fax
Business Location
6330 E SIDEHILL LN
IDAHO FALLS ID, 83401-5902, US
Phone (208) 709-0540
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Idaho
License Number ODP967
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According to our database, Baird Optical Pc NPI is 1013206275, taxonomy code is 152W00000X and license number is ODP967, license state is located at Idaho. Baird Optical Pc physically located at 301 S 4th Ave # C-2, Pocatello ID, 83201-6462. NPI Number 1033115704 has the healthcare provider type.

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1013206275 NPI number is provided on an as is basis without warranty of any kind. 1013206275 is maintained by the National Plan & Provider Enumeration System. The contents of Baird Optical Pc are for informational purposes only.