# PEINE OSTEOPATHIC MEDICINE PLLC

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

## Provider details

- **NPI number:** 1306010046
- **Authorized official:** DR. CHRISTOPHER C PEINE D,O, (OWNER)
- **Authorized official phone:** (208) 947-0925

## Contact information

- **Practice address:** 450 W STATE ST, SUITE 250, EAGLE, ID 83616-7057
- **Practice address phone:** (208) 947-0925
- **Practice address fax:** (208) 947-0926
- **Mailing address:** 450 W STATE ST, SUITE 250, EAGLE, ID 83616-7057
- **Mailing address phone:** (208) 947-0925
- **Mailing address fax:** (208) 947-0926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | O-0366 | ID | Yes |

## Other

- **Enumeration date:** 04/14/2008
- **Last updated:** 04/14/2008