# BREATHE AIRWAY MERIDIAN LLC

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

## Provider details

- **NPI number:** 1275275349
- **Authorized official:** JOHN MCRAE NP (OWNER/PROVIDER)
- **Authorized official phone:** (208) 484-5702

## Contact information

- **Practice address:** 1067 S WELLS ST, MERIDIAN, ID 83642-8596
- **Practice address phone:** (208) 484-5702
- **Mailing address:** 1067 S WELLS ST, MERIDIAN, ID 83642-8596
- **Mailing address phone:** (208) 484-5702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2022
- **Last updated:** 04/10/2022