Ellenbecker Eye Clinic, Pllc
NPI #1205931995 in Coeur D Alene, Idaho
Provider Information
- NPI Number
- 1205931995
- Entity Type
- Organization
- Organization Name
- Ellenbecker Eye Clinic, Pllc
- Primary Specialty
- Optometrist
- Enumeration Date
- Sep 14, 2006
- Last Updated
- Sep 5, 2008
Practice Location
- Address
- 1250 W IRONWOOD DR
- Address 2
- SUITE 201
- City
- Coeur D Alene
- State
- Idaho
- ZIP Code
- 83814-2681
- Phone
- (208) 667-2255
Authorized Official
- Name
- DR. WAYNE D ELLENBECKER, OD
- Title
- OPTOMETRIST/OWNER
- Phone
- (208) 667-2255
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
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