Wilson Polito Pllc

NPI #1285170696 in Moscow, Idaho

Provider Information

NPI Number: 1285170696
Entity Type: Organization
Organization Name: Wilson Polito Pllc
Primary Specialty: Optometrist
Enumeration Date: Jan 9, 2017
Last Updated: Jun 3, 2021

Practice Location

Address: 1844 W PULLMAN RD
City: Moscow
State: Idaho
ZIP Code: 83843-4014
Phone: (208) 883-1800

Authorized Official

Name: DR. NATHAN MICHAEL WILSON, OD
Title: PRESIDENT
Phone: (208) 743-5830

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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