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Organization
EAGLE HEALTH AND WELLNESS, INC
Active
Organization
EAGLE HEALTH AND WELLNESS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE MICHELLE ELSTUN MD (PRESIDENT AND MEDICAL DIRECTOR)
(208) 938-4040
Entity
Organization
Contact information
Practice address
3771 N EAGLE RD, BOISE, ID 83713-5005
(208) 938-4040
(208) 938-4099
Mailing address
3771 N EAGLE RD, BOISE, ID 83713-5005
(208) 938-4040
(208) 938-4099
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCPC-2918
ID
111N00000X
Chiropractor
CHIA-1198
ID
207Q00000X
Family Medicine Physician
Primary
M-9150
ID
Other
Enumeration date
03/04/2010
Last updated
03/04/2010
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