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Organization
BOISE VALLEY DOCTORS, P.A.
Active
Organization
BOISE VALLEY DOCTORS, P.A.
Active
Other names
Firstline Medical
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN ROGER NEUENSCHWANDER M.D. (CEO)
(208) 323-7588
Entity
Organization
Contact information
Practice address
6000 W OVERLAND RD, BOISE, ID 83709-3013
(208) 323-7588
(208) 515-3468
Mailing address
PO BOX 7667, BOISE, ID 83707-1667
(208) 323-7588
(208) 515-3468
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
M-2852
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M-2852
MEDICAL LICENSE
ID
Enumeration date
02/04/2008
Last updated
12/15/2011
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