Individual
DR. JOHN RANDALL PITMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2051 S COLE RD, BOISE, ID 83709-2815
(208) 672-1200
(208) 321-8728
Mailing address
8577 W POOL CT, BOISE, ID 83714-1797
(208) 853-1953
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-715
ID
Other
Enumeration date
02/03/2008
Last updated
02/03/2008
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