Organization
DANIEL L TILLER PA
Active
Other names
Advanced Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODNEY L WHITE O.D. (OWNER)
(208) 466-9251
Entity
Organization
Contact information
Practice address
901 12TH AVE S, NAMPA, ID 83651-4658
(208) 466-9251
(208) 463-1714
Mailing address
901 12TH AVE S, NAMPA, ID 83651-4658
(208) 466-9251
(208) 463-1714
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807007400
—
ID
01
—
V213-4
BLUE CROSS OF IDAHO
ID
Enumeration date
08/24/2005
Last updated
01/14/2010
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