Organization
CENTER FOR COLORECTAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A OLSON MD (MANAGER)
(770) 823-1668
Entity
Organization
Contact information
Practice address
333 N 1ST ST, SUITE 130, BOISE, ID 83702-6100
(770) 823-1668
Mailing address
333 N 1ST ST, SUITE 130, BOISE, ID 83702-6100
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M9825
ID
Other
Enumeration date
03/05/2007
Last updated
08/22/2020
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