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Organization

BOISE VALLEY DOCTORS, P.A.

Active
Other names
Firstline Medical
Organization subpart
No

Provider details

NPI number
Authorized official
ALLEN ROGER NEUENSCHWANDER M.D. (CEO)
(208) 323-7588
Entity
Organization

Contact information

Practice address
6000 W OVERLAND RD, BOISE, ID 83709-3013
(208) 323-7588
(208) 515-3468
Mailing address
PO BOX 7667, BOISE, ID 83707-1667
(208) 323-7588
(208) 515-3468

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
M-2852
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M-2852
MEDICAL LICENSE
ID
Enumeration date
02/04/2008
Last updated
12/15/2011
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