Organization
MRI MOBILE HOLDINGS LIMITED PARTNERSHIP
Active
Other names
MRI Mobile Limited Partnership
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GILES M.D. (CEO/MEDICAL DIRECTOR)
(208) 947-7002
Entity
Organization
Contact information
Practice address
1512 12TH AVENUE ROAD, NAMPA, ID 83686-6008
(208) 947-7002
(208) 947-7003
Mailing address
6225 N MEEKER PLACE, SUITE 130, BOISE, ID 83713-1579
(208) 947-7002
(208) 947-7001
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002641800
—
ID
05
—
070904
—
OR
Enumeration date
05/24/2006
Last updated
12/28/2015
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