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Organization

FAMILY CARE CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURIE MILLER (OFFICE MANAGER)
(208) 321-0634
Entity
Organization

Contact information

Practice address
8050 W RIFLEMAN ST STE 100, BOISE, ID 83704-9000
(208) 321-0634
(208) 321-1082
Mailing address
8050 W RIFLEMAN ST STE 100, BOISE, ID 83704-9000
(208) 321-0634
(208) 321-1082

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002803300
ID
Enumeration date
09/29/2009
Last updated
01/07/2013
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