OrganizationActive
State of Idaho
NPI 1801833454 · Low Vision Rehabilitation Optometrist · Boise, ID
Provider details
- NPI number
- 1801833454
- Entity type
- Organization
- Primary specialty
- Low Vision Rehabilitation OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Angela Roan, Administrator(208) 334-3220
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
120 S Cole Rd
Suite 120 - Bldg 3
Boise, ID 83709-0932
Phone: (208) 334-3220
Fax: (208) 334-2963
Approximate (ZIP-level) locationGet directions
Mailing address
120 S Cole Rd
Boise, ID 83709-0932
Other names (DBA / former)
- Other name
- Idaho Commission for the Blind & Visually Impaired
Registry dates
- Enumerated
- 2006-06-01
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.