Organization
FUNCTIONAL AND INTEGRATIVE MEDICINE OF IDAHO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAIL M. EBERHARTER M.D. (PRESIDENT)
(208) 863-1399
Entity
Organization
Contact information
Practice address
3858 N GARDEN CENTER WAY, SUITE 100, BOISE, ID 83703-5008
(208) 385-7711
(208) 385-0346
Mailing address
2905 W JORDAN ST, BOISE, ID 83702-2134
(208) 863-1399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4631
ID
Other
Enumeration date
11/15/2012
Last updated
01/29/2015
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