Individual
DR. TERRI L HALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
514 OAK ST, SANDPOINT, ID 83864-1480
(208) 265-7965
(208) 265-7965
Mailing address
514 OAK ST, SANDPOINT, ID 83864-1480
(208) 265-7965
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100004
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010137596
REGENCE BLUE SHIELD
ID
01
—
V5418
BLUE CROSS OF IDAHO
ID
Enumeration date
08/11/2005
Last updated
12/04/2007
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