Gary J Lattimore

NPI #1831398643 in Idaho Falls, Idaho

Provider Information

NPI Number: 1831398643
Entity Type: Organization
Organization Name: Gary J Lattimore
Primary Specialty: Optometrist
Enumeration Date: Jul 12, 2007
Last Updated: Feb 28, 2008

Practice Location

Address: 501 S WOODRUFF AVE
City: Idaho Falls
State: Idaho
ZIP Code: 83401-5200
Phone: (208) 522-6271

Authorized Official

Name: MR. GARY J LATTIMORE, O.D.
Title: OPTOMETRIST
Phone: (208) 522-6271

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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