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Individual

LANCE F OUGH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
350 N MILWAUKEE ST, #2153, BOISE, ID 83704-9123
(208) 322-1642
(208) 378-4179
Mailing address
20 QUAIL LN, BOISE, ID 83716-3114
(208) 343-0046

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
ODP 100038
ID

Other

Enumeration date
09/08/2005
Last updated
07/08/2007
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