DR. Gary J Lattimore, OD

NPI #1902863293 in Idaho Falls, Idaho

Provider Information

NPI Number: 1902863293
Entity Type: Individual
Name: DR. Gary J Lattimore, OD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Apr 28, 2006
Last Updated: Jan 22, 2010

Practice Location

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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