Madison Clinic Optometry, P.c.

NPI #1598876997 in Rexburg, Idaho

Provider Information

NPI Number: 1598876997
Entity Type: Organization
Organization Name: Madison Clinic Optometry, P.c.
Primary Specialty: Optometrist
Enumeration Date: Aug 31, 2006
Last Updated: Nov 28, 2007

Practice Location

Address: 244 E MAIN ST
City: Rexburg
State: Idaho
ZIP Code: 83440-2022
Phone: (208) 359-1880

Authorized Official

Name: DR. DALLIN HEINER, O.D.
Title: PRESIDENT
Phone: (208) 359-1880

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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