INTERMOUNTAIN FUNCTIONAL MEDICINE, PLLC
Organization (NPI-2)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1659719177- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 913 S ALLANTE PL, BOISE, ID, 837091612
- Phone
- (208) 947-5390
- Fax
- (208) 947-3465
Specialties & Taxonomies
Nurse Practitioner, Family
Primary License: ID #NP816A