Individual
DR. DALE THOMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4270 N EAGLE RD, BOISE, ID 83713
(208) 938-2010
Mailing address
862 N UNION WAY, STAR, ID 83669-6028
(406) 203-2776
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
MT775
MT
152W00000X
Optometrist
Primary
ODP-100320
ID
Other
Enumeration date
12/14/2006
Last updated
05/14/2018
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