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General NPI Number Information
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NPI Number | 1972684488
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Entity Type | Organization
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Legal Business Name | KLEMP OPTOMETRY
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 10/07/2013
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Provider Practice Location Address
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Address Line | 1910 IDAHO STREET
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City | LEWISTON
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State | ID
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Zip | 83501-2086
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Country | US
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Telephone | 208-743-4022
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Fax | 208-746-0170
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Provider Business Mailing Address
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Address Line | 1910 IDAHO STREET
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City | LEWISTON
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State | ID
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Zip | 83501-2086
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Country | US
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Telephone | 208-743-4022
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Fax | 208-746-0170
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARGARET KLEMP
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Credential |
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Telephone | 208-743-4022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | ODP897
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License Number State | ID
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