Organization
MICAH S MILLS OD PA
Active
Other names
Treasure Valley Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICAH S MILLS OD (OWNER)
(208) 459-2641
Entity
Organization
Contact information
Practice address
1702 S KIMBALL AVE, CALDWELL, ID 83605-4826
(208) 459-2641
(208) 459-2895
Mailing address
1702 S KIMBALL AVE, CALDWELL, ID 83605-4826
(208) 459-2641
(208) 459-2895
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
152WC0802X
Corneal and Contact Management Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972819365
—
ID
01
—
DQ8178
RAILROAD MEDICARE
ID
Enumeration date
08/24/2010
Last updated
02/24/2011
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