| Vitanovu, P.c. | |
|
1525 S Owyhee St Boise ID 83705-6014 | |
| (208) 344-8482 | |
| (208) 345-5426 |
| Full Name | Vitanovu, P.c. |
|---|---|
| Speciality | Clinic/center |
| Location | 1525 S Owyhee St, Boise, Idaho |
| Authorized Official Name and Position | Jenifer Leah Barry (DIRECTOR/OWNER) |
| Authorized Official Contact | 2083448482 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitanovu, P.c. 1525 S Owyhee St Boise ID 83705-6014 Ph: (208) 344-8482 | Vitanovu, P.c. 1525 S Owyhee St Boise ID 83705-6014 Ph: (208) 344-8482 |
| NPI Number | 1821490335 |
|---|---|
| Provider Enumeration Date | 09/16/2014 |
| Last Update Date | 01/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821490335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | M-11233 (Idaho) | Primary |
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