Organization
NORTH IDAHO PLASTIC AND RECONSTRUCTIVE SURGERY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERICK M OWSLEY M.D. (PRESIDENT)
(208) 777-7830
Entity
Organization
Contact information
Practice address
750 N SYRINGA ST, STE 204, POST FALLS, ID 83854-5275
(208) 777-7830
(208) 777-7850
Mailing address
750 N SYRINGA ST, STE 204, POST FALLS, ID 83854-5275
(208) 777-7830
(208) 777-7850
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M-6071
ID
Other
Enumeration date
02/05/2009
Last updated
02/05/2009
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