Individual
BRIAN J MCNEEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
360 E MALLARD DR, STE 110, BOISE, ID 83706-3945
(208) 336-8700
(208) 426-0902
Mailing address
13900 W WAINWRIGHT DR, SUITE 101, BOISE, ID 83713-5028
(208) 938-2010
(208) 938-2011
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP933
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0043208
—
ID
Enumeration date
06/22/2005
Last updated
05/01/2014
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