Organization
OREGON TRAIL EYE CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY PAUL COLLINS O.D. (OWNER)
(208) 547-0000
Entity
Organization
Contact information
Practice address
152 S MAIN ST, SODA SPRINGS, ID 83276-1441
(208) 547-0000
(208) 547-0004
Mailing address
152 S MAIN ST, SODA SPRINGS, ID 83276-1441
(208) 547-0000
(208) 547-0004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100116
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8076769
—
ID
Enumeration date
05/15/2008
Last updated
08/14/2013
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