Organization
ADA VISION CENTER EAST PLLC
Active
Other names
Paul Bigelow OD
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN DOUGLAS HUBER OD (MANAGER)
(208) 514-1858
Entity
Organization
Contact information
Practice address
230 W MALLARD DR STE A, BOISE, ID 83706-3995
(208) 342-4841
Mailing address
1617 E LENZ LN, BOISE, ID 83712-8340
(208) 343-1512
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
08/16/2017
Last updated
08/01/2024
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