Individual
SAMANTHA CRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(083) 815-1112
Mailing address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 381-5111
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
M-14907
ID
Other
Enumeration date
01/28/2011
Last updated
07/20/2020
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