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Organization
FUNCTIONAL AND INTEGRATIVE MEDICINE OF IDAHO PA
Active
Organization
FUNCTIONAL AND INTEGRATIVE MEDICINE OF IDAHO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAIL M. EBERHARTER M.D. (PRESIDENT)
(208) 863-1399
Entity
Organization
Contact information
Practice address
3858 N GARDEN CENTER WAY, SUITE 100, BOISE, ID 83703-5008
(208) 385-7711
(208) 385-0346
Mailing address
2905 W JORDAN ST, BOISE, ID 83702-2134
(208) 863-1399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4631
ID
Other
Enumeration date
11/15/2012
Last updated
01/29/2015
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