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Organization
CENTER FOR PAIN CARE P A
Active
Organization
CENTER FOR PAIN CARE P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLINTON MALLARI MD (ADMINISTRATOR)
(208) 342-4700
Entity
Organization
Contact information
Practice address
115 W MAIN ST, SUITE 102, BOISE, ID 83702-7302
(208) 342-4700
(208) 342-4710
Mailing address
115 W MAIN ST, SUITE 102, BOISE, ID 83702-7302
(208) 342-4700
(208) 342-4710
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
08/01/2006
Last updated
07/19/2007
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