Individual
DR. ERIC DOUGLAS NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
90 HOPE DR, OPTOMETRY CLINIC, MOUNTAIN HOME A F B, ID 83648-1057
(208) 828-7250
(208) 828-1498
Mailing address
1055 E 19TH N, MOUNTAIN HOME, ID 83647-1800
(208) 587-0939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1184
OK
Other
Enumeration date
08/22/2005
Last updated
07/20/2007
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