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Organization
AMH SERIES II ID, LLC
Active
Organization
AMH SERIES II ID, LLC
Active
Other names
Ageless Men's Health
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA WILKINSON (BUSINESS OPERATIONS DIRECTOR)
(702) 818-0446
Entity
Organization
Contact information
Practice address
1545 E IRON EAGLE DR STE 101, EAGLE, ID 83616-7079
(208) 906-9128
Mailing address
1545 E IRON EAGLE DR STE 101, EAGLE, ID 83616-7079
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/21/2022
Last updated
11/11/2024
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