Organization
IDAHO HAND AND WRIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA R RENDON M.D. (M.D./OWNER)
(208) 287-1110
Entity
Organization
Contact information
Practice address
1520 W STATE ST, SUITE 220, BOISE, ID 83702-4038
(208) 287-1110
(208) 287-2010
Mailing address
1520 W STATE ST, SUITE 220, BOISE, ID 83702-4038
(208) 287-1110
(208) 287-2010
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
M9105
ID
Other
Enumeration date
06/06/2006
Last updated
02/21/2008
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