Organization
EYE CARE FOR YOU
Active
Other names
Sandpoint Eyes PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIE BETH GAGNON OD (OWNER PRESIDENT)
(208) 263-9000
Entity
Organization
Contact information
Practice address
710 W. SUPERIOR ST., STE A, SANDPOINT, ID 83864
(208) 263-9000
(208) 263-9589
Mailing address
710 W. SUPERIOR ST., STE A, SANDPOINT, ID 83864
(208) 263-9000
(208) 263-9589
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP895
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010152218
BL SHIELD
—
05
—
002582600
—
ID
05
—
0483922
—
MT
01
—
V3900
BL CROSS
—
Enumeration date
12/26/2006
Last updated
06/23/2008
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