Individual
GUNNAR HARRISON MAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPO, CPO
Contact information
Practice address
9632 W EMERALD ST, BOISE, ID 83704-9762
(208) 866-5177
Mailing address
130 W RIVER HEIGHTS DR, MERIDIAN, ID 83646-5120
(208) 866-5177
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/24/2023
Last updated
02/24/2023
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