Jd Optometrics, LLC
Clinic/Center in Ammon, ID. Organization (NPI-2).
NPI number1790027332
StatusActive
Last updated in NPPESApr 2, 2013
Details
- NPI
- 1790027332
- Entity type
- Organization (NPI-2)
- Legal business name
- Jd Optometrics, LLC
- Organization subpart
- No
- Enumeration date
- Mar 21, 2013
- Last updated
- Apr 2, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | odp 100167 | ID | Yes |
Practice location
1201 S 25th EAmmon, ID 83406-5729
Phone 208-524-8978
Mailing address
1201 S 25th EAmmon, ID 83406-5729
Phone 208-524-8978
Authorized official
Joshua G Davis
Optometrist/President
2087571227
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