Organization · Type 2 NPI
Mangum Primary Care LLC
Primary Care Clinic/Center · Boise, ID
NPI number
1194494229
Active
Practice location
3046 S Bown Way
Boise, ID 83706-5499
Mailing address
608 S Phillippi St
Boise, ID 83705-1160
Other practice locations
- 3050 N Lakeharbor Ln Ste 120, Boise, ID 83703-6917 · (208) 550-3456
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | None listed |
Primary Care Clinic/Center: Definition to come...
Another provider at this address
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About NPI 1194494229
Mangum Primary Care LLC's National Provider Identifier is 1194494229, issued on Sep 11, 2021. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Boise, ID. The record was last updated on Sep 11, 2021.