Individual
DR. LAURA THALIA REIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3000
(208) 463-3046
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 985-1399
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
4513
IA
207Q00000X
Family Medicine Physician
4513
IA
207Q00000X
Family Medicine Physician
Primary
O-0889
ID
Other
Enumeration date
09/08/2009
Last updated
01/23/2017
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