Optic Art Iii, Pllc

NPI #1851663512 in Moscow, Idaho

Provider Information

NPI Number: 1851663512
Entity Type: Organization
Organization Name: Optic Art Iii, Pllc
Primary Specialty: Optometrist
Enumeration Date: Jan 27, 2012
Last Updated: Jan 27, 2012

Practice Location

Address: 213 N MAIN ST
City: Moscow
State: Idaho
ZIP Code: 83843-2700
Phone: (208) 882-2932

Authorized Official

Name: DR. RODGER DEAN ROBERTSON, O.D.
Title: OPTOMETRIC PHYSICIAN
Phone: (208) 882-2932

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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