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Organization

FUNCTIONAL MEDICINE OF IDAHO PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL JAMES WARREN (PRESIDENT)
(208) 385-7711
Entity
Organization

Contact information

Practice address
3858 N GARDEN CENTER WAY STE 100, BOISE, ID 83703-5008
(208) 385-7711
(208) 385-0346
Mailing address
3858 N GARDEN CENTER WAY STE 100, BOISE, ID 83703-5008
(208) 385-7711
(208) 385-0346

Taxonomy

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

Other

Enumeration date
01/03/2018
Last updated
01/03/2018
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