Idaho Physical Medicine & Rehabilitation

NPI #1497969604 in Boise, Idaho

Provider Information

NPI Number: 1497969604
Entity Type: Organization
Organization Name: Idaho Physical Medicine & Rehabilitation
Subpart: Yes (part of a larger organization)
Parent Organization: IDAHO PHYSICAL MEDICINE & REHABILITATION
Primary Specialty: Physician Assistant
Enumeration Date: May 9, 2007
Last Updated: Mar 16, 2010

Practice Location

Address: 600 ROBBINS RD
City: Boise
State: Idaho
ZIP Code: 83702-4539
Phone: (208) 489-4016

Authorized Official

Name: MS. SHARON A LEE
Title: ADMINISTRATOR
Phone: (208) 489-5160

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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