Organization
BONNEVILLE VISION, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN HOUSLEY OD (MANAGING MEMBER)
(208) 523-3937
Entity
Organization
Contact information
Practice address
838 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5296
(208) 523-3937
Mailing address
838 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5296
(208) 523-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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