| Inland Northwest Neuromonitoring Pllc | |
|
950 Bannock Street, Suite 1100 Boise ID 83702 | |
| (210) 598-4277 | |
| Not Available |
| Full Name | Inland Northwest Neuromonitoring Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Clinical Neurophysiology |
| Location | 950 Bannock Street, Suite 1100, Boise, Idaho |
| Authorized Official Name and Position | Roxanna Laroque (DIRECTOR OF CLIENT EXPERIENCE) |
| Authorized Official Contact | 2105982801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inland Northwest Neuromonitoring Pllc 1141 N Loop 1604 E #105-612 San Antonio TX 78232 Ph: (210) 598-4277 | Inland Northwest Neuromonitoring Pllc 950 Bannock Street, Suite 1100 Boise ID 83702 Ph: (210) 598-4277 |
| NPI Number | 1790321966 |
|---|---|
| Provider Enumeration Date | 11/22/2019 |
| Last Update Date | 07/07/2022 |
| Certification Date | 07/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790321966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (* (Not Available)) | Primary |
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