Individual
DR. LAVAR W KOFOED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
291 N MILWAUKEE ST, BOISE, ID 83704-9132
(208) 378-7020
(208) 378-9460
Mailing address
291 N MILWAUKEE ST, BOISE, ID 83704-9132
(208) 378-7020
(208) 375-7970
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-972
ID
Other
Enumeration date
04/11/2007
Last updated
04/14/2010
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