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Organization

BOISE DERMAESTHETICS, LLC

Active
Other names
McConnehey Family Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
CHERYL D LUNDY (BILLING MANGER)
(208) 452-6794
Entity
Organization

Contact information

Practice address
6126 W EMERALD ST, BOISE, ID 83704-8857
(208) 323-6525
Mailing address
6126 W EMERALD ST, BOISE, ID 83704-8857
(208) 323-6525

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
06/04/2006
Last updated
09/12/2007
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