Eyedaho Optometric LLC

NPI #1417627480 in Idaho Falls, Idaho

Provider Information

NPI Number: 1417627480
Entity Type: Organization
Organization Name: Eyedaho Optometric LLC
Primary Specialty: Optometrist
Enumeration Date: Sep 20, 2021
Last Updated: Sep 20, 2021

Practice Location

Address: 500 S UTAH AVE
City: Idaho Falls
State: Idaho
ZIP Code: 83402-3305
Phone: (208) 528-8643

Authorized Official

Name: DR. TREVOR DICKSON, OD
Title: OWNER
Phone: (208) 709-5371

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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