Individual
ALLYSON J KOMORI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
500 W FORT ST # 111, SUITE 202, BOISE, ID 83702-4501
(208) 695-3774
Mailing address
500 W FORT ST. #111, BOISE, ID 83702
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MRO1313
ID
Other
Enumeration date
06/21/2011
Last updated
07/22/2013
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