Glen S Lovelace MD PA

NPI #1023053204 in Boise, Idaho

Provider Information

NPI Number: 1023053204
Entity Type: Organization
Organization Name: Glen S Lovelace MD PA
Primary Specialty: Specialist
Enumeration Date: Jun 19, 2006
Last Updated: Jun 1, 2009

Practice Location

Address: 333 N 1ST ST STE 260
City: Boise
State: Idaho
ZIP Code: 83702-6132
Phone: (208) 345-3136

Authorized Official

Name: DR. GLEN S LOVELACE, MD
Title: OWNER
Phone: (208) 345-3136

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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