Organization
TWO RIVERS MEDICAL GROUP
Active
Organization
TWO RIVERS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN PRETTYWEASEL (OWNER, CEO)
(208) 283-7691
Entity
Organization
Contact information
Practice address
7568 FERRIS AVE, BOISE, ID 83714-5508
(208) 283-7691
Mailing address
PO BOX 1311, EAGLE, ID 83616-1311
(088) 283-7691
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/31/2019
Last updated
12/20/2023
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