Organization
CARTER VISION CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MOYER (BILLING MANAGER)
(208) 713-0104
Entity
Organization
Contact information
Practice address
1157 E PUFFIN ST, MERIDIAN, ID 83642-7444
(208) 880-6891
Mailing address
1157 E PUFFIN ST, MERIDIAN, ID 83642-7444
(208) 880-6891
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100084
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891789368
INDIVIDUAL NPI
ID
05
—
807254900
—
ID
Enumeration date
11/11/2010
Last updated
11/11/2010
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