Teton Retinal Institute PA

NPI #1437274057 in Ammon, Idaho

Provider Information

NPI Number: 1437274057
Entity Type: Organization
Organization Name: Teton Retinal Institute PA
Primary Specialty: Ophthalmology
Enumeration Date: Mar 20, 2007
Last Updated: Nov 18, 2015

Practice Location

Address: 3544 E 17TH ST
Address 2: STE 105
City: Ammon
State: Idaho
ZIP Code: 83406-6911
Phone: (208) 535-4900

Authorized Official

Name: DR. DARRYL G MOFFETT JR., MD
Title: PRESIDENT
Phone: (208) 535-4900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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