Organization
IDAHO EYE PROS IDAHO FALLS LLC
Active
Other names
Idaho Eye Pros, Eye Pros
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREL GEORGE (ACCOUNT MANAGER)
(208) 954-9106
Entity
Organization
Contact information
Practice address
2990 S 25TH E, IDAHO FALLS, ID 83404-6515
(208) 535-2604
(208) 522-0861
Mailing address
3485 N COLE RD UNIT 45479, BOISE, ID 83711-1095
(208) 297-7019
(208) 297-7518
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20006642
PTAN
ID
Enumeration date
09/24/2013
Last updated
03/26/2021
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