Organization
DUPUYTREN'S CENTER
Active
Organization
DUPUYTREN'S CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL MALLOW (OFFICE MANAGER)
(208) 344-5628
Entity
Organization
Contact information
Practice address
351 SW 9TH ST, ONTARIO, OR 97914-2639
(208) 344-5628
(208) 345-2907
Mailing address
1007 N 6TH ST, BOISE, ID 83702-4339
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO14247
OR
Other
Enumeration date
05/24/2007
Last updated
08/22/2020
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