Organization
CT CLANCY MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISON DUNBAR (BILLING MANAGER)
(208) 954-5572
Entity
Organization
Contact information
Practice address
413 N ALLUMBAUGH ST, SUITE 101, BOISE, ID 83704-9212
(208) 323-1125
(208) 323-9604
Mailing address
413 N ALLUMBAUGH ST, SUITE 101, BOISE, ID 83704-9212
(208) 323-1125
(208) 323-9604
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M-11479
ID
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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