Organization
EAGLE HEALTH AND WELLNESS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE MICHELLE ELSTUN MD (PRESIDENT AND MEDICAL DIRECTOR)
(208) 938-4040
Entity
Organization
Contact information
Practice address
3771 N EAGLE RD, BOISE, ID 83713-5005
(208) 938-4040
(208) 938-4099
Mailing address
3771 N EAGLE RD, BOISE, ID 83713-5005
(208) 938-4040
(208) 938-4099
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCPC-2918
ID
111N00000X
Chiropractor
CHIA-1198
ID
207Q00000X
Family Medicine Physician
Primary
M-9150
ID
Other
Enumeration date
03/04/2010
Last updated
03/04/2010
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