Organization
GRANITE MOUNTAIN SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER L ELLIOTT MD (OWNER)
(208) 412-4530
Entity
Organization
Contact information
Practice address
8950 W EMERALD ST STE 195, BOISE, ID 83704-8296
(208) 999-3034
Mailing address
8950 W EMERALD ST STE 195, BOISE, ID 83704-8296
(208) 999-3034
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
02/24/2025
Last updated
02/24/2025
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