Individual
LYNN F. SHENK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
600 N ROBBINS RD STE 300, BOISE, ID 83702-4539
(208) 706-0400
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
10954
MT
208100000X
Physical Medicine & Rehabilitation Physician
Primary
M-17779
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000092646
BCBS PIN
MT
01
—
0151424
MDCD PIN
MT
01
—
122153100
MDCD PIN
WY
Enumeration date
11/05/2006
Last updated
07/08/2024
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