# NORTHWEST OCCUPATIONAL MEDICINE & NEUROSURGICAL SPINE INSTITUTE LLC

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

## Provider details

- **NPI number:** 1619539897
- **Authorized official:** DR. PAUL JOSEPH MONTALBANO MD (OWNER)
- **Authorized official phone:** (208) 327-5600

## Contact information

- **Practice address:** 8921 W HACKAMORE DR, BOISE, ID 83709-1673
- **Practice address phone:** (208) 375-1105
- **Practice address fax:** (208) 377-7707
- **Mailing address:** 6140 W CURTISIAN AVE STE 400, BOISE, ID 83704-8907
- **Mailing address phone:** (208) 327-5631
- **Mailing address fax:** (208) 327-5602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/08/2019
- **Last updated:** 05/09/2022