Individual
DR. RYAN DOUGLAS HUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
27 N FISHER PARK WAY STE 101, EAGLE, ID 83616-4795
(208) 514-1858
(844) 840-3190
Mailing address
27 N FISHER PARK WAY STE 101, EAGLE, ID 83616-4795
(208) 514-1858
(208) 576-6951
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100228
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558657783
—
ID
Enumeration date
06/27/2011
Last updated
05/17/2022
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