Boise Dermaesthetics, Llc | |
6126 W Emerald St Boise ID 83704-8857 | |
(208) 323-6525 | |
Not Available |
Full Name | Boise Dermaesthetics, Llc |
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Speciality | Family Medicine |
Location | 6126 W Emerald St, Boise, Idaho |
Authorized Official Name and Position | Cheryl D Lundy (BILLING MANGER) |
Authorized Official Contact | 2084526794 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Boise Dermaesthetics, Llc 6126 W Emerald St Boise ID 83704-8857 Ph: (208) 323-6525 | Boise Dermaesthetics, Llc 6126 W Emerald St Boise ID 83704-8857 Ph: (208) 323-6525 |
NPI Number | 1639117153 |
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Provider Enumeration Date | 06/04/2006 |
Last Update Date | 09/12/2007 |
Identifier | Type | State | Issuer |
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1639117153 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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