Individual
MRS. TRICIA LEE PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
639 W 275 S, BLACKFOOT, ID 83221-6332
(208) 681-6177
Mailing address
639 W 275 S, BLACKFOOT, ID 83221-6332
(208) 681-6177
Taxonomy
Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
—
—
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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