PAIN CARE CLINIC OF IDAHO P.C. NPI 1982093357

NPI Information

PAIN CARE CLINIC OF IDAHO, P.C. is a pain clinic center in Eagle, ID. PAIN CARE CLINIC OF IDAHO, P.C. NPI is 1982093357. The provider is registered as an organization entity type.

The provider's business location address is:

742 E STATE ST
SUITE 150
EAGLE, ID
ZIP 83616-941
Phone: (208) 939-3750
Fax: (208) 939-3754

The provider's authorized official is Edmund C Boese .
The authorized official title is Owner and has the following contact phone number (208) 939-3750.

The enumeration date for this NPI number is 1/22/2015 and was last updated on 1/22/2015.

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:

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