Organization
WILSON POLITO PLLC
Active
Other names
Alpine Vision Center, Alpine Vision Center, Wilson Polito Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN WILSON OD (OPTOMETRIST/PRESIDENT)
(720) 212-8821
Entity
Organization
Contact information
Practice address
739 BRYDEN AVE STE A, LEWISTON, ID 83501-4909
(208) 743-5830
(208) 743-5831
Mailing address
872 TROY RD STE 130, MOSCOW, ID 83843-5035
(720) 212-8821
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100222
ID
Other
Enumeration date
04/04/2011
Last updated
11/06/2020
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