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Organization
TREASURE VALLEY METABOLIC MEDICINE
Active
Organization
TREASURE VALLEY METABOLIC MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATY CONNLEY (CEO, OWNER)
(208) 830-6773
Entity
Organization
Contact information
Practice address
951 E PLAZA DR STE 110, EAGLE, ID 83616-6567
(208) 274-9580
(208) 274-9581
Mailing address
951 E PLAZA DR STE 110, EAGLE, ID 83616-6567
(208) 274-9580
(208) 274-9581
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Enumeration date
12/04/2019
Last updated
03/23/2021
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