Organization
FOR YOUR EYES ONLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY JAMES LATTIMORE O.D. (OPTOMETRIC PHYSICIAN)
(208) 522-6271
Entity
Organization
Contact information
Practice address
501 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5200
(208) 522-6271
(208) 522-7217
Mailing address
501 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5200
(208) 522-6271
(208) 522-7217
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
505
ID
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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