Individual
SCOTT BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
206 S COLE RD, BOISE, ID 83709-0934
(208) 830-0016
(208) 939-8731
Mailing address
206 S COLE RD, BOISE, ID 83709-0934
(208) 830-0016
(208) 939-8731
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
DME20447
ID
332BC3200X
Customized Equipment (DME)
DME20447
ID
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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