Individual
DR. BRIAN W GOLTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2347 E GALA ST, MERIDIAN, ID 83642-4881
(208) 323-0031
(208) 323-0064
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 323-0031
(208) 323-0064
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
M-7838
ID
Other
Enumeration date
06/29/2006
Last updated
01/23/2014
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