| Functional Medicine Of Idaho Pc | |
|
3858 N Garden Center Way Ste 100 Boise ID 83703-5008 | |
| (208) 385-7711 | |
| (208) 385-0346 |
| Full Name | Functional Medicine Of Idaho Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3858 N Garden Center Way Ste 100, Boise, Idaho |
| Authorized Official Name and Position | Samuel James Warren (PRESIDENT) |
| Authorized Official Contact | 2083857711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Functional Medicine Of Idaho Pc 3858 N Garden Center Way Ste 100 Boise ID 83703-5008 Ph: (208) 385-7711 | Functional Medicine Of Idaho Pc 3858 N Garden Center Way Ste 100 Boise ID 83703-5008 Ph: (208) 385-7711 |
| NPI Number | 1336656040 |
|---|---|
| Provider Enumeration Date | 01/03/2018 |
| Last Update Date | 01/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336656040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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