Individual
JUSTIN LAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPSGT
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 989-5121
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
PSG-087
ID
Other
Enumeration date
05/14/2019
Last updated
09/02/2021
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