Organization
IDAHO EYECARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOWARD MUTO O.D. (PRESIDENT)
(208) 384-9194
Entity
Organization
Contact information
Practice address
1175 W BOISE AVE, BOISE, ID 83706-3503
(208) 384-9194
(208) 384-9327
Mailing address
1175 W BOISE AVE, BOISE, ID 83706-3503
(208) 384-9194
(208) 384-9327
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-612
ID
Other
Enumeration date
10/03/2006
Last updated
06/15/2023
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