Organization
MARY E RIVER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E RIVER MD (OWNER)
(208) 381-3699
Entity
Organization
Contact information
Practice address
222 N 2ND ST, SUITE 103, BOISE, ID 83702-6109
(208) 381-3699
(208) 381-3697
Mailing address
222 N 2ND ST, SUITE 103, BOISE, ID 83702-6109
(208) 381-3699
(208) 381-3697
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M8111
ID
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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