Organization · Type 2 NPI
Idaho Physical Medicine and Rehabilitation PA
Ambulatory Surgical Clinic/Center · Meridian, ID
NPI number
1497949705
Active
Practice location
3551 E Overland Road
Meridian, ID 83642
Mailing address
PO Box 1128
Boise, ID 83701-1128
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | None listed |
| Ambulatory Surgical Clinic/Center Primary | 261QA1903X | None listed |
Ambulatory Surgical Clinic/Center: Definition to come...
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About NPI 1497949705
Idaho Physical Medicine and Rehabilitation PA's National Provider Identifier is 1497949705, issued on Aug 29, 2007. The primary taxonomy on file is Ambulatory Surgical Clinic/Center (261QA1903X), and the practice location is in Meridian, ID. The record was last updated on Jun 5, 2014.