Lake Harbor Internal Medicine

NPI 1083800015 - Specialist - 174400000X

NPI Details
NPI 1083800015
Enumeration Date 09/24/2007
Last Updated 09/24/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name KERILYNN KERILYNN
Position OWNER
Phone (208) 853-4556
Fax (208) 853-5544
Practice Location
3684 N HARBOR LN
BOISE ID, 83703-6914, US
Phone (208) 853-4556
Fax (208) 853-5544
Business Location
3684 N HARBOR LN
BOISE ID, 83703-6914, US
Phone (208) 853-4556
Fax (208) 853-5544
Toxanomy
Taxonomy Code 174400000X
License State
License Number
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According to our database, Lake Harbor Internal Medicine NPI is 1083800015, taxonomy code is 174400000X Lake Harbor Internal Medicine physically located at 3684 N Harbor Ln, Boise ID, 83703-6914. NPI Number 1033115704 has the healthcare provider type.

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1083800015 NPI number is provided on an as is basis without warranty of any kind. 1083800015 is maintained by the National Plan & Provider Enumeration System. The contents of Lake Harbor Internal Medicine are for informational purposes only.