Organization
VISION QUEST MEDICAL CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB ADAM MONG MD (PRESIDENT)
(208) 377-3937
Entity
Organization
Contact information
Practice address
1906 FAIRVIEW AVE STE 100, CALDWELL, ID 83605-5433
(208) 377-3937
(208) 377-9455
Mailing address
5680 W GAGE ST, BOISE, ID 83706-1326
(208) 377-3937
(208) 377-9455
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
O-0860
ID
Other
Enumeration date
08/10/2018
Last updated
08/10/2018
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