| Restored Horizons | |
|
14775 N Kimo Ct Suite B Rathdrum ID 83858-8762 | |
| (208) 687-5627 | |
| Not Available |
| Full Name | Restored Horizons |
|---|---|
| Speciality | Family Medicine |
| Location | 14775 N Kimo Ct, Rathdrum, Idaho |
| Authorized Official Name and Position | Michael Whiting (PRESIDENT) |
| Authorized Official Contact | 2086875627 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restored Horizons 14775 N Kimo Ct Suite B Rathdrum ID 83858-8762 Ph: (208) 687-5627 | Restored Horizons 14775 N Kimo Ct Suite B Rathdrum ID 83858-8762 Ph: (208) 687-5627 |
| NPI Number | 1669572780 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 03/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669572780 | NPI | - | NPPES |
| DA0692 | Other | ID | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M8126 (Idaho) | Primary |
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