Individual
DR. NATHAN LEE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
(208) 828-7250
Mailing address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
(208) 828-7250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100562
ID
Other
Enumeration date
12/20/2005
Last updated
05/19/2022
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