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Individual

DR. PHILIP DAVID RAINEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2051 S COLE RD, BOISE, ID 83709-2815
(208) 672-1200
Mailing address
679 N DUNBARTON PL, STAR, ID 83669-5681
(208) 514-6405
(208) 955-2735

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP 100143
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0799974
ID
Enumeration date
10/03/2007
Last updated
01/06/2016
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