OPTIMAL HEATLH MEDICAL INSTITURE NPI 1184865883

NPI Information

OPTIMAL HEATLH MEDICAL INSTITURE is a preventive medicine/occupational environmental medicine preventive medicine in Boise, ID. The provider is a preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. OPTIMAL HEATLH MEDICAL INSTITURE NPI is 1184865883. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3224 N MAPLE GROVE RD
BOISE, ID
ZIP 83704-214
Phone: (208) 495-3688
Fax: (208) 475-4924

The provider's authorized official is Ralph M Sutherlin .
The authorized official title is Owner/physician and has the following contact phone number (208) 495-3688.

The CLIA number assigned to this NPI record is 13D2035917 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/10/2009 and was last updated on 3/10/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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