Bradley L Rhinehart Od Pa | |
700 E 17th St, Idaho Falls, ID 83404-6152 | |
(208) 522-2839 | |
Not Available |
Full Name | Bradley L Rhinehart Od Pa |
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Type | Facility |
Speciality | Optometrist |
Location | 700 E 17th St, Idaho Falls, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700063567 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | ODP-100062 (Idaho) | Primary |
Provider Name | Bradley L Rhinehart |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1356457030 PECOS PAC ID: 0840232872 Enrollment ID: I20080826000392 |
Mailing Address | Practice Location Address |
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Bradley L Rhinehart Od Pa Po Box 3579, Idaho Falls, ID 83403-3579 Ph: (208) 525-2090 | Bradley L Rhinehart Od Pa 700 E 17th St, Idaho Falls, ID 83404-6152 Ph: (208) 522-2839 |
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