Individual
JUDITH LAUREN CHASIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
435 S EAGLE RD, SUITE 100, EAGLE, ID 83616-6067
(208) 939-8200
(208) 939-8222
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
222464
NY
207Q00000X
Family Medicine Physician
Primary
M11185
ID
Other
Enumeration date
07/06/2007
Last updated
09/26/2014
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