Organization
GRANGE OPHTHALMOLOGY, PLLC
Active
Other names
Grange Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA RAE NOLDER (OFFICE MANAGER)
(208) 989-7151
Entity
Organization
Contact information
Practice address
450 W STATE ST STE 250, EAGLE, ID 83616-6974
(208) 506-7966
(208) 277-3857
Mailing address
450 W STATE ST STE 250, EAGLE, ID 83616-6974
(208) 506-7966
(208) 277-3857
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
04/08/2022
Last updated
08/15/2023
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