Organization
EYECENTER PA
Active
Parent organization
EYECENTER PA
Other names
Twin Falls Eyecenter
Organization subpart
Yes
Provider details
NPI number
Legal business name
EYECENTER PA
Authorized official
ROBERT B GRILL OD (OWNER OPTOMETRIST)
(208) 734-9800
Entity
Organization
Contact information
Practice address
844 SHOSHONE ST E, TWIN FALLS, ID 83301-6336
(208) 734-9800
(208) 734-9433
Mailing address
844 SHOSHONE ST E, TWIN FALLS, ID 83301-6336
(208) 734-9800
(208) 734-9433
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP7637
TRAVELERS RR MEDICARE GRP
—
Enumeration date
10/07/2006
Last updated
01/08/2008
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