Individual
DR. CLINTON MALLARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 W MAIN ST, SUITE 102, BOISE, ID 83702-7302
(208) 342-4700
(208) 342-4710
Mailing address
115 W MAIN ST, SUITE 102, BOISE, ID 83702-7302
(208) 342-4700
(208) 342-4710
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
M6287
ID
Other
Enumeration date
07/27/2006
Last updated
07/09/2007
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