Individual
JEFFREY C JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7960 W RIFLEMAN ST, SUITE #150, BOISE, ID 83704-9066
(208) 377-8899
Mailing address
7960 W RIFLEMAN ST., SUITE #150, BOISE, ID 83704-9066
(208) 377-8899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP843
ID
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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