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Organization
TREASURE VALLEY FOOT AND ANKLE
Active
Organization
TREASURE VALLEY FOOT AND ANKLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK A JOHNSON (PRESIDENT)
(208) 546-9548
Entity
Organization
Contact information
Practice address
3120 W BELLTOWER DR STE 100, MERIDIAN, ID 83646-7744
(208) 516-3617
(208) 314-2029
Mailing address
PO BOX 268, BOUNTIFUL, UT 84011-0268
(208) 516-3617
(208) 314-2029
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
08/20/2019
Last updated
12/16/2019
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