Organization
INTERMOUNTIAN PEDIATRIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN LOUISE JAMBURA RN BSN (OFFICE MANAGER)
(208) 322-1325
Entity
Organization
Contact information
Practice address
7722 W USTICK RD, BOISE, ID 83704-5845
(208) 322-1325
(208) 327-0393
Mailing address
7722 W USTICK RD, BOISE, ID 83704-5845
(208) 322-1325
(208) 327-0393
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/05/2024
Last updated
07/05/2024
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