Organization
EYEDAHO OPTOMETRIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREVOR DICKSON OD (OWNER)
(208) 709-5371
Entity
Organization
Contact information
Practice address
500 S UTAH AVE, IDAHO FALLS, ID 83402-3305
(208) 709-5371
Mailing address
2951 STONEWOOD CIR, AMMON, ID 83406-8123
(208) 709-5371
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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