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Individual

AMY MARIE NEIDEFFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1702 S KIMBALL AVE, CALDWELL, ID 83605-4826
(208) 459-2641
(208) 459-2895
Mailing address
1702 S KIMBALL AVE, CALDWELL, ID 83605-4826

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
3189
OK
152W00000X
Optometrist
Primary
ODP-100618
ID
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/11/2022
Last updated
08/14/2023
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