Organization
BLUEBIRD FAMILY EYE CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CODY JONES OD (OWNER)
(208) 785-7274
Entity
Organization
Contact information
Practice address
720 N MERIDIAN ST STE A, BLACKFOOT, ID 83221-4936
(208) 785-7274
(208) 785-7274
Mailing address
720 N MERIDIAN ST STE A, BLACKFOOT, ID 83221-4936
(208) 785-7274
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WV0400X
Vision Therapy Optometrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477793222
—
ID
Enumeration date
12/03/2019
Last updated
01/16/2020
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