Organization
MOUNTAIN WEST MEDICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN KENNETH MCRAE DNP, NPH, BSN (DR. OF NURSE PRACTIONER)
(208) 229-8739
Entity
Organization
Contact information
Practice address
1067 S WELLS ST, SUITE#110, MERIDIAN, ID 83642-7997
(208) 229-8739
(208) 895-8540
Mailing address
1067 S WELLS ST, SUITE#110, MERIDIAN, ID 83642-7997
(208) 229-8739
(208) 895-8540
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
54169
ID
Other
Enumeration date
11/28/2016
Last updated
07/07/2023
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