Organization
EAGLE VISION CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN TAYLOR GALBRAITH OD (DOCTOR)
(208) 356-6911
Entity
Organization
Contact information
Practice address
74 E 1ST S, REXBURG, ID 83440-1936
(208) 356-6911
(208) 356-3185
Mailing address
74 E 1ST S, REXBURG, ID 83440-1936
(208) 356-6911
(208) 356-3185
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP100035
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807725600
—
ID
Enumeration date
09/05/2007
Last updated
11/21/2012
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