Organization
PAIN MANAGEMENT OF NORTH IDAHO, PLLC
Active
Organization
PAIN MANAGEMENT OF NORTH IDAHO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA MARIE BOTAI (PRACTICE ADMINISTRATOR)
(208) 765-4807
Entity
Organization
Contact information
Practice address
1686 W RIVERSTONE DR, STE 1, COEUR D ALENE, ID 83814-5779
(208) 765-4807
(208) 765-2903
Mailing address
1686 W RIVERSTONE DR, STE 1, COEUR D ALENE, ID 83814-5779
(208) 765-4807
(866) 573-0853
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
M7860
ID
Other
Enumeration date
03/07/2007
Last updated
06/26/2025
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