Organization
INTEGRATIVE MEDICINE OF LEWISTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURT A BAILEY (OWNER)
(208) 799-3333
Entity
Organization
Contact information
Practice address
3510 12TH ST STE 200, LEWISTON, ID 83501-5575
(208) 799-3333
(208) 799-3375
Mailing address
3510 12TH ST STE 200, LEWISTON, ID 83501-5575
(208) 799-3333
(208) 799-3375
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-1087A
ID
Other
Enumeration date
08/15/2011
Last updated
08/15/2011
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