| Renu Medispa | |
|
951 E Plaza Dr Suite 150 Eagle ID 83616-6566 | |
| (208) 939-4456 | |
| (208) 287-2200 |
| Full Name | Renu Medispa |
|---|---|
| Speciality | Clinic/center |
| Location | 951 E Plaza Dr, Eagle, Idaho |
| Authorized Official Name and Position | Tawni Weaver (DIRECTOR) |
| Authorized Official Contact | 2089394456 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renu Medispa 951 E Plaza Dr Suite 150 Eagle ID 83616-6566 Ph: (208) 939-4456 | Renu Medispa 951 E Plaza Dr Suite 150 Eagle ID 83616-6566 Ph: (208) 939-4456 |
| NPI Number | 1407129125 |
|---|---|
| Provider Enumeration Date | 02/10/2012 |
| Last Update Date | 04/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407129125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | NP784A (Idaho) | Primary |
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