| Sparkmd | |
|
302 W Idaho St Boise ID 83702-6039 | |
| (208) 369-4590 | |
| Not Available |
| Full Name | Sparkmd |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 302 W Idaho St, Boise, Idaho |
| Authorized Official Name and Position | Julie Kristen Gunther (OWNER, PHYSICIAN) |
| Authorized Official Contact | 2083694590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparkmd 302 W Idaho St Boise ID 83702-6039 Ph: (208) 369-4590 | Sparkmd 302 W Idaho St Boise ID 83702-6039 Ph: (208) 369-4590 |
| NPI Number | 1427443613 |
|---|---|
| Provider Enumeration Date | 04/03/2015 |
| Last Update Date | 04/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427443613 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | M-10803 (Idaho) | Primary |
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