Organization
STATE OF IDAHO
Active
Other names
Idaho Commission for the Blind & Visually Impaired
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA ROAN (ADMINISTRATOR)
(208) 334-3220
Entity
Organization
Contact information
Practice address
120 S COLE RD, SUITE 120 - BLDG 3, BOISE, ID 83709-0932
(208) 334-3220
(208) 334-2963
Mailing address
120 S COLE RD, SUITE 120 - BLDG 3, BOISE, ID 83709-0932
(208) 334-3220
(208) 334-2963
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
—
—
Other
Enumeration date
06/01/2006
Last updated
08/22/2020
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