The Pediatric and Adolescent Center, Inc.

NPI #1144341637 in Boise, Idaho

Provider Information

NPI Number: 1144341637
Entity Type: Organization
Organization Name: The Pediatric and Adolescent Center, Inc.
Primary Specialty: Legal Medicine
Enumeration Date: Apr 2, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 6148 N DISCOVERY WAY
Address 2: SUITE 100
City: Boise
State: Idaho
ZIP Code: 83713-0201
Phone: (208) 322-5437

Authorized Official

Name: WILLIAM SULLIVAN BOURQUARD, M.D
Title: OWNER
Phone: (208) 322-5437

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Legal Medicine	173000000X	Primary

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