Organization
ALLANTE PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN RODNEY JOHNSEN MD (OWNER)
(208) 377-5433
Entity
Organization
Contact information
Practice address
909 S ALLANTE PL, BOISE, ID 83709-1612
(208) 377-5433
Mailing address
909 S ALLANTE PL, BOISE, ID 83709-1612
(208) 377-5433
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
08/05/2009
Last updated
09/03/2019
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