OrganizationActive
Advanced Vision Therapy Center LLC
NPI 1669808846 · Vision Therapy Optometrist · Boise, ID
Provider details
- NPI number
- 1669808846
- Entity type
- Organization
- Primary specialty
- Vision Therapy OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Kendall Johnson, Manager(208) 377-1310
Specialties & taxonomies
Eye and Vision Services Providers
- Sports Vision Optometrist152WS0006X
Eye and Vision Services Providers
Practice location
7960 W Rifleman St
Suite 150
Boise, ID 83704-9064
Phone: (208) 377-1310
Fax: (208) 321-1952
Approximate (ZIP-level) locationGet directions
Mailing address
7960 W Rifleman St
Boise, ID 83704-9064
Registry dates
- Enumerated
- 2013-09-19
- Last updated
- 2013-09-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.