Individual
TREVOR DELPHOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
641 N HAYES ST, MOSCOW, ID 83843-3238
(208) 596-8988
Mailing address
641 N HAYES ST, MOSCOW, ID 83843-3238
(208) 596-8988
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
12/01/2020
Last updated
05/08/2023
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