Organization
CHILDREN'S CLEAR VISION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON CLARK NIELSEN OD (OPTOMETRIST)
(208) 284-0650
Entity
Organization
Contact information
Practice address
568 FALLS AVE, TWIN FALLS, ID 83301-3314
(208) 284-0650
Mailing address
568 FALLS AVE, TWIN FALLS, ID 83301-3314
(208) 284-0650
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100311
ID
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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