TABLE ROCK MOBILE MEDICINE PLLC is a family nurse practitioner in Boise, ID. TABLE ROCK MOBILE MEDICINE PLLC NPI is 1194186437. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
1111 S ORCHARD ST STE 251
BOISE, ID
ZIP 83705-964
Phone: (986) 224-8420
Fax: (208) 504-2821
The provider's authorized official is Bradley Bigford .
The authorized official title is Sole Member and has the following contact phone number (986) 224-8420.
The CLIA number assigned to this NPI record is 13D2113001 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 3/15/2016 and was last updated on 9/2/2021.