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Organization
CENTER FOR LIFETIME HEALTH
Active
Organization
CENTER FOR LIFETIME HEALTH
Active
Other names
Colleen Shackelford, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN SHACKELFORD DNP (OWNER)
(208) 342-7400
Entity
Organization
Contact information
Practice address
300 E BANNOCK ST, BOISE, ID 83712
(208) 342-7400
(208) 342-1879
Mailing address
300 E BANNOCK ST, BOISE, ID 83712
(208) 342-7400
(208) 342-1879
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M5741
ID
Other
Enumeration date
11/08/2006
Last updated
07/25/2023
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