Organization
ICA CATH LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LINEBERGER (EXECUTIVE DIRECTOR)
(208) 685-2109
Entity
Organization
Contact information
Practice address
6140 W CURTISIAN, STE 300, BOISE, ID 83704
(208) 322-1680
(208) 322-1695
Mailing address
6140 W CURTISIAN, STE 300, BOISE, ID 83704
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/23/2006
Last updated
08/22/2020
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