Individual
DR. JEREMIAH GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
710 W SUPERIOR ST STE B, SANDPOINT, ID 83864-1684
(208) 263-9000
Mailing address
710 W SUPERIOR ST STE B, SANDPOINT, ID 83864-1684
(208) 946-7187
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODO-100614
ID
Other
Enumeration date
05/30/2023
Last updated
06/12/2023
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