Bear River Vision, LLC

Organization Active NPI Optometrist · Soda Springs, ID

NPI 1922115443 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1922115443
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
0-536 (ID)
Legal business name
BEAR RIVER VISION, LLC
Practice address
380 S 3Rd W
Soda Springs, ID 83276-1559
Phone
(208) 547-2114
Fax
(208) 547-2020
NPI assigned
Aug 23, 2006
Organization subpart
No

Authorized official

Name
Dr. Terry Howard Sanderson, O.D.
Title
Optometry/Owner
Phone
(208) 547-2114

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

380 S 3rd W
Soda Springs, ID 83276
Phone (208) 547-2020

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X 0-536 ID Yes

Addresses

Primary practice location

380 S 3Rd W
Soda Springs, ID 83276-1559

Mailing address

380 S 3Rd W
Soda Springs, ID 83276-1559
Phone (208) 547-2114

Other providers in Soda Springs, ID

All providers in Soda Springs, ID · Optometrist in Idaho

Sources for this page

Verify at the official NPI Registry.