| Bore LLC | |
|
1498 Midway Ave Ste 2 Ammon ID 83406-4587 | |
| (208) 529-9930 | |
| Not Available |
| Full Name | Bore LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1498 Midway Ave Ste 2, Ammon, Idaho |
| Authorized Official Name and Position | Heather Fumich (CONTRACTING) |
| Authorized Official Contact | 5035020655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bore LLC 1498 Midway Ave Ste 2 Ammon ID 83406-4587 | Bore LLC 1498 Midway Ave Ste 2 Ammon ID 83406-4587 Ph: (208) 529-9930 |
| NPI Number | 1447880570 |
|---|---|
| Provider Enumeration Date | 01/16/2020 |
| Last Update Date | 01/16/2020 |
| Certification Date | 01/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447880570 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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