Individual
SLAVIK OSIPCHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
987 S ALLANTE PL, BOISE, ID 83709-1612
(208) 947-7246
(208) 297-7772
Mailing address
987 S ALLANTE PL, BOISE, ID 83709-1612
(208) 947-7246
(208) 297-7772
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
62202
ID
363L00000X
Nurse Practitioner
62202
ID
Other
Enumeration date
04/30/2020
Last updated
01/14/2025
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