Organization
IDAHO EYE PROS OF NAMPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAVAR W KOFOED OD (OWNWE)
(208) 378-7020
Entity
Organization
Contact information
Practice address
16449 MIDLAND BLVD, NAMPA, ID 83687-5222
(208) 467-7020
(208) 467-7022
Mailing address
16449 MIDLAND BLVD, NAMPA, ID 83687-5222
(208) 467-7020
(208) 467-7022
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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