Individual
BRIAN J MCKEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1480 E LINCOLN RD, IDAHO FALLS, ID 83401-2128
(208) 525-8686
(208) 525-8684
Mailing address
1480 E LINCOLN RD, IDAHO FALLS, ID 83401-2128
(208) 525-8686
(208) 525-8684
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
111111
ID
Other
Enumeration date
06/21/2022
Last updated
06/27/2022
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