Individual
MR. TAYLOR TRENT WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
291 N MILWAUKEE ST STE A-3, BOISE, ID 83704-9132
(833) 776-2020
(208) 297-7518
Mailing address
3485 N COLE RD UNIT 45479, BOISE, ID 83711-1095
(833) 776-2020
(208) 297-7518
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100538
ID
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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