Organization
NEUROPATHY CLINIC L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIANNE ALICE HULL REGISTERED NURSE (DIRECTOR)
(208) 682-2547
Entity
Organization
Contact information
Practice address
401 7TH ST, WALLACE, ID 83873-2335
(208) 752-1019
(208) 752-1063
Mailing address
214 CYPRESS ST, WALLACE, ID 83873-2122
(208) 682-2547
(208) 752-1063
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
N6485
HI
Other
Enumeration date
06/25/2007
Last updated
08/22/2020
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