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Individual

DR. VITALIY PELIKHATYY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D

Contact information

Practice address
8359 W EMERALD ST, BOISE, ID 83704-8304
(208) 321-0901
Mailing address
8359 W EMERALD ST, BOISE, ID 83704-8304
(360) 721-7293

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
100541
ID

Other

Enumeration date
10/07/2009
Last updated
06/08/2023
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