Organization
NORTH IDAHO PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA MARIE BOTAI (PRACTICE ADMINISTRATOR)
(208) 765-4807
Entity
Organization
Contact information
Practice address
1686 W RIVERSTONE DR STE 2, COEUR D ALENE, ID 83814-5779
(208) 765-4807
(208) 765-2903
Mailing address
1686 W RIVERSTONE DR, STE 2, COEUR D ALENE, ID 83814-5779
(208) 765-4807
(208) 765-2903
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
13C0001058
ID
Other
Enumeration date
01/26/2006
Last updated
06/26/2025
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