Organization
SNAKE RIVER EYE ASSOCIATES OF SHELLEY, PLLC
Active
Other names
Snake River Eye Associates of Shelley, PLLC, Snake River Eyecare LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS RADFORD OD (OWNER)
(208) 881-5145
Entity
Organization
Contact information
Practice address
357 W FIR ST, SHELLEY, ID 83274-1456
(208) 881-5145
(208) 881-5146
Mailing address
PO BOX K, SHELLEY, ID 83274-0910
(208) 881-5145
(208) 881-5146
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366794299
—
ID
Enumeration date
10/02/2012
Last updated
11/14/2025
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