Family Practice Medical

NPI #1649392200 in Boise, Idaho

Provider Information

NPI Number: 1649392200
Entity Type: Organization
Organization Name: Family Practice Medical
Primary Specialty: Social Worker
Enumeration Date: Apr 4, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 777 N RAYMOND ST
City: Boise
State: Idaho
ZIP Code: 83704-9251
Phone: (208) 367-6030

Authorized Official

Name: MR. TOM C AHLRICHS, LCSW
Title: SOCIAL WORKER
Phone: (208) 367-6030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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