person
Scott Lee Lillemo
Optician in Hayden, Idaho
NPI 1316169543

Scott Lee Lillemo is a Optician based in Hayden, ID and is specialized in Optician. Scott Lee Lillemo practices in Hayden, ID. The NPI Number for Scott Lee Lillemo is 1316169543 and holds a License No. (Idaho).

The current practice location address for Scott Lee Lillemo is 8827 N Government Way, Hayden, ID and can be reached out via phone at 208-762-3455.

Location: 8827 N Government Way, Hayden, ID, 83835-8231
person
Provider Profile Details
NPI Number
1316169543
Provider Name
Scott Lee Lillemo
Credential
Provider Entity Type
Individual
Gender
Male
Address
8827 N Government Way, Hayden, ID, 83835-8231
Phone Number
208-762-3455
Fax Number
Provider Enumeration Date
05/03/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
V7778 01 ID BLUE CROSS OF IDAHO
000010138836 01 ID REGENCE BLUE SHIELD OF ID
institution
Provider Business Practice Location Address Details
Address
8827 N Government Way
City
State
Zip
83835-8231
Phone Number
208-762-3455
Fax Number
person
Provider Business Mailing Address Details
Address
8827 N Government Way
City
State
Zip
83835-8231
Phone Number
208-762-3455
Fax Number
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
()
Definition
Definition to come...
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