| Boise Dermaesthetics, LLC | |
|
6126 W Emerald St Boise ID 83704-8857 | |
| (208) 323-6525 | |
| Not Available |
| Full Name | Boise Dermaesthetics, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 6126 W Emerald St, Boise, Idaho |
| Authorized Official Name and Position | Cheryl D Lundy (BILLING MANGER) |
| Authorized Official Contact | 2084526794 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boise Dermaesthetics, LLC 6126 W Emerald St Boise ID 83704-8857 Ph: (208) 323-6525 | Boise Dermaesthetics, LLC 6126 W Emerald St Boise ID 83704-8857 Ph: (208) 323-6525 |
| NPI Number | 1639117153 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 09/12/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639117153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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