# IDAHO HAND AND WRIST

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

## Provider details

- **NPI number:** 1891734729
- **Authorized official:** LISA R RENDON M.D. (M.D./OWNER)
- **Authorized official phone:** (208) 287-1110

## Contact information

- **Practice address:** 1520 W STATE ST, SUITE 220, BOISE, ID 83702-4038
- **Practice address phone:** (208) 287-1110
- **Practice address fax:** (208) 287-2010
- **Mailing address:** 1520 W STATE ST, SUITE 220, BOISE, ID 83702-4038
- **Mailing address phone:** (208) 287-1110
- **Mailing address fax:** (208) 287-2010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207XS0106X | Orthopaedic Hand Surgery Physician | M9105 | ID | Yes |

## Other

- **Enumeration date:** 06/06/2006
- **Last updated:** 02/21/2008