Individual
DR. RUSTIN M HATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
526 SHOUP AVE W, STE H, TWIN FALLS, ID 83301
(208) 733-2400
(208) 734-0343
Mailing address
526 SHOUP AVE W, STE H, TWIN FALLS, ID 83301
(208) 733-2400
(208) 734-0343
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100048
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806835700
—
ID
Enumeration date
01/25/2006
Last updated
03/12/2008
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