Individual
GREGORY CODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5372 W WATERWHEEL DR, BOISE, ID 83703-3132
(208) 996-9333
Mailing address
5372 W WATERWHEEL DR, BOISE, ID 83703-3132
(208) 996-3333
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-4296
ID
Other
Enumeration date
08/23/2017
Last updated
12/05/2024
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