Organization
MERRELL EYECARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHALL H MERRELL O.D. (OWNER)
(208) 359-2020
Entity
Organization
Contact information
Practice address
345 N 2ND E STE 1, REXBURG, ID 83440-1603
(208) 359-2020
(208) 534-9997
Mailing address
345 N 2ND E STE 1, REXBURG, ID 83440-1603
(208) 359-2020
(208) 534-9997
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP813
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992894232
—
ID
Enumeration date
02/17/2011
Last updated
03/24/2017
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