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Organization

IVIE FAMILY VISION PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JARED REESE IVIE O.D. (OWNER/OPTOMETRIST)
(208) 529-2700
Entity
Organization

Contact information

Practice address
2405 JAFER CT, IDAHO FALLS, ID 83404-5587
(208) 529-2700
(208) 529-0873
Mailing address
2405 JAFER CT, IDAHO FALLS, ID 83404-5587
(208) 529-2700
(208) 529-0873

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP100241
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1285852599
ID
Enumeration date
08/06/2014
Last updated
06/21/2023
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