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Individual

MARNEE OVERDUYN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7905 W USTICK RD, STE E, BOISE, ID 83704-5001
(208) 322-6211
(208) 322-6304
Mailing address
7905 W USTICK RD, STE E, BOISE, ID 83704-5001
(208) 322-6211
(208) 322-6304

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447439674
ID
Enumeration date
08/29/2016
Last updated
08/29/2016
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