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Organization

EAST BOISE COUNTY MEDICAL CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LYNDA JOANNE MARICLE-KUWAHARA APRN-C (EXECUTIVE DIRECTOR)
(208) 392-4544
Entity
Organization

Contact information

Practice address
3852 HIGHWAY 21, BOISE, ID 83716
(208) 392-4544
(208) 392-4128
Mailing address
3852 HIGHWAY 21, BOISE, ID 83716
(208) 392-4544
(208) 392-4128

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ID

Other

Enumeration date
11/19/2011
Last updated
11/19/2011
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