Organization
COMPLETE CARE AUDIOLOGY INC.
Active
Other names
Boise Speech and Hearing Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BREK D STOKER AUD CCCA (OWNER)
(208) 376-3591
Entity
Organization
Contact information
Practice address
13176 PERSIMMON LN, # 120, BOISE, ID 83713-1986
(208) 376-3591
(208) 376-3594
Mailing address
13176 PERSIMMON LN, # 120, BOISE, ID 83713-1986
(208) 376-3591
(208) 376-3594
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
H412
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010143633
BLUE SHIELD OF IDAHO
ID
01
—
AU191
BLUE CROSS
ID
Enumeration date
05/25/2006
Last updated
04/02/2008
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