Organization
LIFE QUEST CENTER INC
Active
Organization
LIFE QUEST CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD THOMPSON (CEO)
(208) 283-7895
Entity
Organization
Contact information
Practice address
3355 N FIVE MILE RD, STE 284, BOISE, ID 83713-3925
(208) 283-7895
Mailing address
3355 N FIVE MILE RD, STE 284, BOISE, ID 83713-3925
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M6839
ID
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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