Ica Cath Lab LLC

NPI #1205881851 in Boise, Idaho

Provider Information

NPI Number: 1205881851
Entity Type: Organization
Organization Name: Ica Cath Lab LLC
Primary Specialty: Internal Medicine
Enumeration Date: May 23, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 6140 W CURTISIAN
Address 2: STE 300
City: Boise
State: Idaho
ZIP Code: 83704
Phone: (208) 322-1680

Authorized Official

Name: JAMES LINEBERGER
Title: EXECUTIVE DIRECTOR
Phone: (208) 685-2109

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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