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Organization

JOHN T RIETZ

Active
Other names
OPTOMETRIC VISION CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN T RIETZ OD (OPTOMETRIST)
(208) 746-3626
Entity
Organization

Contact information

Practice address
1616 19TH AVE, LEWISTON, ID 83501-4005
(208) 746-3626
(208) 746-1636
Mailing address
1616 19TH AVE, LEWISTON, ID 83501-4005
(208) 746-3626
(208) 746-1636

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002674300
ID
05
2012219
WA
Enumeration date
04/02/2007
Last updated
11/05/2009
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