|
| |
|
409 W Neider Ave Ste C, Coeur D Alene, ID 83815-9423 | |
| (208) 765-5665 | |
| (208) 765-1716 |
| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 409 W Neider Ave Ste C, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184854408 | NPI | - | NPPES |
| 1184854408 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | ODP-906 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
409 W Neider Ave Ste C, Coeur D Alene, ID 83815-9423 Ph: (208) 765-5665 | 409 W Neider Ave Ste C, Coeur D Alene, ID 83815-9423 Ph: (208) 765-5665 |
Roy Lavern Clapper, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 355 E Neider Ave, Coeur D Alene, ID 83815 Phone: 208-676-7356 Fax: 208-676-7384 | |
Dr. Cindy L Ellenbecker, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1250 W Ironwood Dr, Coeur D Alene, ID 83814 Phone: 208-667-2255 Fax: 208-765-5889 | |
Kelsi Butherus, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 355 E Neider Ave, Coeur D Alene, ID 83815 Phone: 208-676-7356 | |
Ellenbecker Eye Clinic, Pllc Optometrist Medicare: Medicare Enrolled Practice Location: 1250 W Ironwood Dr, Suite 201, Coeur D Alene, ID 83814 Phone: 208-667-2255 Fax: 208-765-5889 |