Functional And Integrative Medicine Of Idaho Pa

NPI 1740524701 - Family Medicine - 207Q00000X

NPI Details
NPI 1740524701
Enumeration Date 11/15/2012
Last Updated 01/29/2015
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name GAIL M. GAIL
Position PRESIDENT
Phone (208) 385-7711
Fax (208) 385-0346
Practice Location
3858 N GARDEN CENTER WAY
SUITE 100
BOISE ID, 83703-5008, US
Phone (208) 385-7711
Fax (208) 385-0346
Business Location
2905 W JORDAN ST
BOISE ID, 83702-2134, US
Phone (208) 863-1399
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Idaho
License Number M4631
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According to our database, Functional And Integrative Medicine Of Idaho Pa NPI is 1740524701, taxonomy code is 207Q00000X and license number is M4631, license state is located at Idaho. Functional And Integrative Medicine Of Idaho Pa physically located at 3858 N Garden Center Way, Boise ID, 83703-5008. NPI Number 1033115704 has the healthcare provider type.

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1740524701 NPI number is provided on an as is basis without warranty of any kind. 1740524701 is maintained by the National Plan & Provider Enumeration System. The contents of Functional And Integrative Medicine Of Idaho Pa are for informational purposes only.