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Individual

WILLIAM TRAVIS FREMONT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
11298 W STALLION LN, BOISE, ID 83713-5236
(208) 817-0303
Mailing address
1350 S FIVE MILE RD # 190893, BOISE, ID 83709-1305
(208) 817-0303

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
ID

Other

Enumeration date
11/23/2022
Last updated
06/08/2023
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Product
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  • Eligibility checks
  • EDI platform