Organization
NORTH IDAHO FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS WADE BOZARTH PA-C (OWNER)
(208) 770-8848
Entity
Organization
Contact information
Practice address
1101 E POLSTON AVE STE B, POST FALLS, ID 83854-6045
(208) 770-8848
Mailing address
1101 E POLSTON AVE STE B, POST FALLS, ID 83854-6045
(208) 747-1776
(208) 747-1777
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/31/2025
Last updated
03/10/2025
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