Organization
VITANOVU, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENIFER LEAH BARRY M.D. (DIRECTOR/OWNER)
(208) 344-8482
Entity
Organization
Contact information
Practice address
1525 S OWYHEE ST, BOISE, ID 83705-6014
(208) 344-8482
(208) 345-5426
Mailing address
1525 S OWYHEE ST, BOISE, ID 83705-6014
(208) 344-8482
(208) 345-5426
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
M-11233
ID
Other
Enumeration date
09/16/2014
Last updated
01/26/2016
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