# BOISE BRAIN AND BODY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073403051
- **Authorized official:** EDWARD A ANTON (OWNER)
- **Authorized official phone:** (818) 861-6481

## Contact information

- **Practice address:** 711 N CURTIS RD, BOISE, ID 83706-1445
- **Practice address phone:** (208) 605-3000
- **Mailing address:** 6568 S FEDERAL WAY \# 238, BOISE, ID 83716-9277
- **Mailing address phone:** (818) 861-6481

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081P0301X | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P0301X | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/09/2025
- **Last updated:** 06/17/2026