Individual
JAMIE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1155 POCATELLO CREEK RD, POCATELLO, ID 83201-2949
(208) 233-2020
(208) 233-2021
Mailing address
1155 POCATELLO CREEK RD, POCATELLO, ID 83201-2949
(208) 233-2020
(208) 233-2021
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP100029
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002446900
—
ID
Enumeration date
09/23/2005
Last updated
04/13/2011
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