Idaho Allergy L.l.c.

NPI #1477866606 in Eagle, Idaho

Provider Information

NPI Number: 1477866606
Entity Type: Organization
Organization Name: Idaho Allergy L.l.c.
Primary Specialty: Allergy & Immunology - Allergy
Enumeration Date: Jul 16, 2010
Last Updated: Jun 17, 2016

Practice Location

Address: 379 E SHORE DR
Address 2: SUITE 100
City: Eagle
State: Idaho
ZIP Code: 83616-5410
Phone: (208) 938-3443

Authorized Official

Name: DR. STEPHEN B FRITZ, M.D.
Title: PRESIDENT
Phone: (208) 938-3443

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Allergy & Immunology - Allergy — Allergy	207KA0200X	Primary

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