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Organization
FAMILY & FUNCTIONAL MEDICINE OF IDAHO PLLC
Active
Organization
FAMILY & FUNCTIONAL MEDICINE OF IDAHO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA L HOUSE DO (PHYSICIAN / OWNER)
(208) 947-0925
Entity
Organization
Contact information
Practice address
450 W STATE ST, SUITE 250, EAGLE, ID 83616-7057
(208) 947-0925
(208) 947-0926
Mailing address
450 W STATE ST, SUITE 250, EAGLE, ID 83616-7057
(208) 947-0925
(208) 947-0926
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0-O370
ID
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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