Individual
MS. PAIVI BRACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1407 WEST MCMILLAN ROAD, SUITE 120, MERIDIAN, ID 83646
(208) 315-6717
(208) 315-6718
Mailing address
P.O. BOX 1662, MERIDIAN, ID 83680
(208) 315-6717
(208) 315-6718
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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