Organization
ALLIANCE MEDICAL GROUP, LLC
Active
Organization
ALLIANCE MEDICAL GROUP, LLC
Active
Other names
Primary Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PETERMAN MD (PRESIDENT)
(208) 955-6522
Entity
Organization
Contact information
Practice address
6052 W STATE ST, BOISE, ID 83703-2739
(208) 344-7799
(208) 344-7152
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2008
Last updated
02/18/2011
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