Individual
DR. JUSTIN MARK ROWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
339 DEINHARD LN, MCCALL, ID 83638-4703
(208) 634-2020
(208) 634-1716
Mailing address
204 LENORA ST, MCCALL, ID 83638-3844
(208) 634-4161
(208) 634-1716
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618001924
VA
152W00000X
Optometrist
Primary
ODP-100139
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598954638
—
ID
Enumeration date
10/15/2007
Last updated
12/13/2022
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