NPI 1013943828

Leon C Peterson, OD

Practitioner Optometrist Idaho Falls, ID

Practice location

Address: 501 S Woodruff Ave, Idaho Falls, ID 83401-5200
Phone: (208) 522-6271
Fax: (208) 522-7217

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence ODP535 (ID)

Other Optometrist providers in Idaho →

Registry record

NPI: 1013943828
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jun 2006
Record last updated: 13 Mar 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.