Individual
SPENCER FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-4100
(208) 814-4908
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
O-1977
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2019
Last updated
07/30/2024
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