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Organization
SPEROVUE, LLC
Active
Organization
SPEROVUE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN MANWARING DNP, APRN, PMHNP-BC (CEO)
(208) 615-9400
Entity
Organization
Contact information
Practice address
784 S CLEARWATER LOOP STE D, POST FALLS, ID 83854-9599
(208) 615-9400
Mailing address
1311 E CENTRAL DR, MERIDIAN, ID 83642-7991
(208) 615-6400
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/03/2021
Last updated
12/21/2021
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