West Dawn LLC

NPI #1790529030 in Paul, Idaho

Provider Information

NPI Number: 1790529030
Entity Type: Organization
Organization Name: West Dawn LLC
Primary Specialty: Optometrist
Enumeration Date: Jun 21, 2024
Last Updated: Aug 2, 2024

Practice Location

Address: 218 EAST ELLIS STREET
City: Paul
State: Idaho
ZIP Code: 83347
Phone: (208) 629-6173

Authorized Official

Name: ERIC WESTON WOODWARD, OD
Title: OWNER
Phone: (208) 800-6003

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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