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Individual

ALLYSON R ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 322-7018
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
(208) 322-7018

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M11511
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306157466
ID
Enumeration date
06/23/2010
Last updated
02/23/2015
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