Individual
PHILLIP IMPERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
633 N 4TH ST, BOISE, ID 83702-4510
(208) 342-9800
Mailing address
633 N 4TH ST, BOISE, ID 83702-4510
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/05/2024
Last updated
05/13/2025
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