Passport to Independence,llc

NPI #1275790081 in Nampa, Idaho

Provider Information

NPI Number
1275790081
Entity Type
Organization
Organization Name
Passport to Independence,llc
Primary Specialty
Clinic/Center - Occupational Medicine
Enumeration Date
May 20, 2008
Last Updated
May 20, 2008

Practice Location

Address
764 W HEATHER WOODS DR
City
Nampa
State
Idaho
ZIP Code
83686-2685
Phone
(208) 461-4882

Authorized Official

Name
MR. MICHAEL ANTHONY TRIOLO, RPH
Title
BUSINESS MANAGER
Phone
(208) 461-4882

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Occupational MedicineOccupational Medicine

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