Individual
IAN PENWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPM
Contact information
Practice address
2829 N CITRUS PL, BOISE, ID 83713-5185
(208) 585-8788
(208) 629-5614
Mailing address
2829 N CITRUS PL, BOISE, ID 83713-5185
(208) 585-8788
(208) 629-5614
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
Other
Enumeration date
10/28/2009
Last updated
10/28/2009
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