Organization
BORE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER FUMICH (CONTRACTING)
(503) 502-0655
Entity
Organization
Contact information
Practice address
1498 MIDWAY AVE STE 2, AMMON, ID 83406-4587
(208) 529-9930
Mailing address
1498 MIDWAY AVE STE 2, AMMON, ID 83406-4587
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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