Clearwater Valley Optical

NPI #1457544306 in Lewiston, Idaho

Provider Information

NPI Number: 1457544306
Entity Type: Organization
Organization Name: Clearwater Valley Optical
Primary Specialty: Ophthalmology
Enumeration Date: Aug 23, 2007
Last Updated: Aug 23, 2007

Practice Location

Address: 2214 VINEYARD AVE
City: Lewiston
State: Idaho
ZIP Code: 83501-6352
Phone: (208) 743-2241

Authorized Official

Name: DR. EUGENE M BALDECK, M.D.
Title: PHYSICIAN/OWNER
Phone: (208) 743-2241

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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