| Ted Wenzel | |
|
8436 W Fairview Ave Suite D Boise ID 83704-0144 | |
| (208) 338-5249 | |
| (208) 338-5579 |
| Full Name | Ted Wenzel |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8436 W Fairview Ave, Boise, Idaho |
| Authorized Official Name and Position | Ted Wenzel (OWNER) |
| Authorized Official Contact | 2083760480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ted Wenzel 8436 W Fairview Ave Suite D Boise ID 83704-0144 Ph: (208) 338-5249 | Ted Wenzel 8436 W Fairview Ave Suite D Boise ID 83704-0144 Ph: (208) 338-5249 |
| NPI Number | 1265879548 |
|---|---|
| Provider Enumeration Date | 05/28/2013 |
| Last Update Date | 05/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265879548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Idaho) | Primary |
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