Individual
WILLIAM KOWALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 W FORT ST # 111R, BOISE, ID 83702-4599
(208) 422-1000
Mailing address
2511 S NANTUCKET WAY, BOISE, ID 83706-5096
(208) 890-3492
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3071460
ID
Other
Enumeration date
03/22/2025
Last updated
06/01/2025
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